Usacomplaints.com » Health & Medicine » Complaint / Review: Medicare & Kaiser Senior Advantage - Changing plans is a guaranteed nightmare. #304994

Complaint / Review
Medicare & Kaiser Senior Advantage
Changing plans is a guaranteed nightmare

In October '07, I contacted a Medical Insurer to get Supplemental Coverage for my 94yr old mother's medical insurance coverage. I told the salesman that my mother was currently with Kaiser's Senior Advantage and I wanted to get her out of Kaiser.

He had me/her apply to his company and to find a prescription drug company. I did both and she was approved by his company.

Mid December '07, Kaiser sent me a letter date 12/12/07, stating that my mother's health coverage would terminate as of 12/31/07. Come January '08, Kaiser withdrew from our checking account the monthly premium, so I called and they said that she was cancelled and then reinstated. They said that they would reimburse us. I wrote a letter to Kaiser stating that she was no longer with Kaiser so please terminate the deduction from our account. Kaiser followed the letter and the reimbursement came two months later.

Meanwhile during the first three months of mom had gone to three doctor appts. Medicare denied coverage stating that mom had another primary... Kaiser.

So I started calling Medicare and Kaiser. Each would blame the other and neither would take the control or walk it through. Medicare would not take your phone number and said that they cannot call you back, per policy.

Medicare for the most part had agents that listened, but you were to know to go up a step and ask for a supervisor, again they could not work with you beyond the phone call. And other agents and supervisor would say that the other supervisor did something wrong or didn't do enough.

Where at Kaiser they acted like it wasn't their fault or their concern. One Kaiser supervisor said that she would check something and get back to me. She left a message the next day and stated that they would issue a letter too. The letter arrived stating that Kaiser had terminated my mother as of 00/00/00... What the hell???

So I called the Kaiser supervisor back and left her a message about the end date on the letter. She had someone else call me to say that the date was 12/31/07, but no replacement letter was sent out.

While this bs is going on, I get a letter from the Drug Insurance Company saying that Medicare denied them becasue I had coverage through Kaiser Senior Advantage and they sent all the premiums that I had paid for the year so far back. Strangely I remember that about 3-4 wks previously Medicare sent me a form letter saying that I didn't have Drug Insurance Coverage... How was that possible if they say I have Kaiser and denied the Drug Ins Company I signed up with.

FINALLY a Medicare supervisor says that this may take 4-6 weeks to be corrected... But I'm losing trust. I am due to have surgery within the next two mos and I want this rectified before I go in so that the bills don't end up in collections.

Five days later the Drug Insurance Companies and says that Medicare accepted them and they would rebill us. But a day later I get a benefit summary showing the two medical bills and showing that coverage was denied because my mother was covered by another company Kaiser Senior Advantage.

So I called Medicare and after dealing with one condesending agent who hung up on me, I got a supervisor that could not tell me exactly what she saw on her computer, but that one bill had been paid.

So now I wait... To see if that was the final chapter, or if just volume 1 of a zillion more.
I'm 53, I can't imagine what a 90 yr old with dementia would do with this.



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