Over and over again, I am glad that I chose regular Medicare with a top of the line supplemental policy. Don’t need referrals, although in some cases my doctor sends them anyway, no co-pays, I can go to any doctor or facility that takes Medicare and in 9 years, including treatments for a fractured pelvis and a hip replacement, costs have been covered 100%.
You're right & you're lucky. No American should need luck to get the necessary & proper healthcare they NEED.
I believe another major crisis with traditional Medicare--what you have, Nancy, started with Geo W Bush, continued with Obama and went full bore and on steroids with Felon 45 during Covid.
What that "plan" was was to privatize traditional Medicare. It's now on a firm, steady track to replace all recipients of TM with privatized Medicare (Dis)Advantage plans. So you're luck is running out, unfortunately. Biden hasn't done anything to fix this, either.
Every year because more & more seniors can't afford TM & a Medigap policy, they are forced into signing with a MA plan. Already over 1/2 of all Medicare eligible seniors are on MA plans. That's the direction US is headed and there is a deadline coming up where YOU WON'T have a choice!
As it stands now, every year, MA plans--their greedy CEOs, steal away between $80-$120 BILLION taxpaid $$$$ away from funding we paid into from the Medicare trustfund into these CEOs' bank accounts. Profits--instead of healthcare to the elderly that need it. And that's done by denials and deferrals just like this article pointed out. And if you're elderly, who has money for an attorney?
I joined an organization mostly made up of medical professionals (but anybody can join) that care about their patients & are fighting back called PNHP.org. Physicians for National Health Program. They are up against a Goliath.
I would love to hear, see, Harris talking about changing this back but there's also a lot on her plate right now.
Nothing changes unless and until The People decide to take action and change things. That's our history.
It’s the TransAmerica Life Insurance company under their Medicare supplemental plans. I did a lot of research before I chose them. I have Plan F which is no longer offered by any supplemental plan, my guess is that it’s too generous, smile. It pays my Plan B deductible so I don’t even pay that and pays for overseas medical care although we haven’t (yet anyway) traveled overseas. I think that Plan G is almost the equivalent and is probably still offered by all supplemental companies. All supplemental policies of any letter have to offer the same coverage as I recall. It’s just choosing the company that carries it that counts. TransAmerica has covered every charge that Medicare itself didn’t cover or any excess. I’ve not had one issue with them in the 9 years I’ve had them. My general health has always been very good but when something happens to me it’s usually something big which is why I chose Medicare and supplemental over letting my husband put me on his Advantage plan. He pays lots of co-pays and deductibles but his pension covers part of the cost of the plan so that’s why he took it. He was able to cover me separately for the dental and eye care but it doesn’t pay much and we always end up paying out of pocket each year for one or the other or both because of that. He has had some issues getting referrals approved in a timely manner with BCBS which is what his plan offers, but he’s never been denied coverage so that’s good. He often has to call to nudge the process along. I Paid $1200 a year when I started at age 62. I now pay $1800 a year but the surgeries and ER visits and an ambulance ride once, all covered, has more than made up for the yearly cost. Some years I only have my annual checkup to claim but on the years when something goes wrong, the charges come fast and furious.
Great read- I’ve gotta ask the question here… why was the health plan brought into this. In your explanation of the back injury - she pulled her back moving a child- seems like a workers compensation situation and not a health plan as the injury resulted while under control of the employer.
It would be helpful if this post had told us on what basis United said they were denying the surgery. What alternative treatment did they recommend? Nowadays, there are a number of minimally invasive disc procedures - ? less expensive than traditional laminectomy. That said, private health insurance and its obscene profits and inefficiency have long been killing US healthcare and needs to go away. Single-payer coverage is the best solution. Please check out Physicians for a National Health Program and join the cause!
Thank you! I'm a member myself--just another concerned elderly citizen, not any medical pro. We are up against a King Kong of healthcare greedy CEOs.
To not even suggest another procedure, not give actual reasons for this denial, it's clear as day this decision is all about corporate greed.
I recently read that Wall Street bankers have advised CEOs on these healthcare insurance companies that they aren't pulling in enough profits lately and warned them they need to do more.
What do you think that means for the poor patients all involved?
Biden hasn't done anything to correct this trajectory from mostly Felon 45's plan of moving everyone on TM to MA plans. And I certainly don't hear Harris even talking about it. Democratic party leaders have plenty to worry about currently, but that has to change.
And none of this matters if Rethuglicons steal power, again, in November.
I have United Healthcare as my supplemental insurance with Medicare. I have never had a problem. I have had knee replacement surgery, hip replacement surgery and a fractured hip that was repaired. Medicare payed and United Healthcare paid the difference. Something isn't right with this. I think there is more to the story
A dedicated Special Ed teacher should not have to remain in pain when a standard surgery would allow her to continue serving her community. UHC needs government oversight to curb their abhorrent practices. I wish Robin well and hope she gets the care she most assuredly deserves.
Too much information missing from this article to jump to conclusions. I find it interesting they never mention the reason for denial 3 times. That’s a big part of it. Also sounds like it should be workers comp if it happened at work. What else has been tried or have they said surgery is the first option? If she is self insured she should be contact HR and the benefits department, if it’s being denied it’s due to the plan she is in and the benefits chosen and HR/Benefits can decide to allow it.
I can certainly relate to this. This exact situation has happened to me. United Healthcare is the worst at paying when needed and they definitely deny claims that the medical doctor and team deemed necessary. I’m definitely gathering all information needed and speaking with a lawyer concerning them not wanting to approve and cover medical surgeries and procedures recommended by a medical doctor. They eventually approved my surgery, however, I had to go through hell and high water to get it approved FINALLY. 😏😩 I do not recommend United Healthcare to anyone as they don’t mind deducting their money from your paychecks weekly but don’t want to cover medical procedures recommended by your doctor.
Ms. Ginkel is 43 and not on medicare nor medigap. Most of these comments do not apply here. United is 5th wealthiest corporate entity on the fortune 500 and has the 10th largest revenue globally. How do we think they made their billions in health insurance? On denying care for millions of policy holders like Ms. Ginkel!
Over and over again, I am glad that I chose regular Medicare with a top of the line supplemental policy. Don’t need referrals, although in some cases my doctor sends them anyway, no co-pays, I can go to any doctor or facility that takes Medicare and in 9 years, including treatments for a fractured pelvis and a hip replacement, costs have been covered 100%.
You're right & you're lucky. No American should need luck to get the necessary & proper healthcare they NEED.
I believe another major crisis with traditional Medicare--what you have, Nancy, started with Geo W Bush, continued with Obama and went full bore and on steroids with Felon 45 during Covid.
What that "plan" was was to privatize traditional Medicare. It's now on a firm, steady track to replace all recipients of TM with privatized Medicare (Dis)Advantage plans. So you're luck is running out, unfortunately. Biden hasn't done anything to fix this, either.
Every year because more & more seniors can't afford TM & a Medigap policy, they are forced into signing with a MA plan. Already over 1/2 of all Medicare eligible seniors are on MA plans. That's the direction US is headed and there is a deadline coming up where YOU WON'T have a choice!
As it stands now, every year, MA plans--their greedy CEOs, steal away between $80-$120 BILLION taxpaid $$$$ away from funding we paid into from the Medicare trustfund into these CEOs' bank accounts. Profits--instead of healthcare to the elderly that need it. And that's done by denials and deferrals just like this article pointed out. And if you're elderly, who has money for an attorney?
I joined an organization mostly made up of medical professionals (but anybody can join) that care about their patients & are fighting back called PNHP.org. Physicians for National Health Program. They are up against a Goliath.
I would love to hear, see, Harris talking about changing this back but there's also a lot on her plate right now.
Nothing changes unless and until The People decide to take action and change things. That's our history.
Which supplemental plan do you have? That is fantastic.
It’s the TransAmerica Life Insurance company under their Medicare supplemental plans. I did a lot of research before I chose them. I have Plan F which is no longer offered by any supplemental plan, my guess is that it’s too generous, smile. It pays my Plan B deductible so I don’t even pay that and pays for overseas medical care although we haven’t (yet anyway) traveled overseas. I think that Plan G is almost the equivalent and is probably still offered by all supplemental companies. All supplemental policies of any letter have to offer the same coverage as I recall. It’s just choosing the company that carries it that counts. TransAmerica has covered every charge that Medicare itself didn’t cover or any excess. I’ve not had one issue with them in the 9 years I’ve had them. My general health has always been very good but when something happens to me it’s usually something big which is why I chose Medicare and supplemental over letting my husband put me on his Advantage plan. He pays lots of co-pays and deductibles but his pension covers part of the cost of the plan so that’s why he took it. He was able to cover me separately for the dental and eye care but it doesn’t pay much and we always end up paying out of pocket each year for one or the other or both because of that. He has had some issues getting referrals approved in a timely manner with BCBS which is what his plan offers, but he’s never been denied coverage so that’s good. He often has to call to nudge the process along. I Paid $1200 a year when I started at age 62. I now pay $1800 a year but the surgeries and ER visits and an ambulance ride once, all covered, has more than made up for the yearly cost. Some years I only have my annual checkup to claim but on the years when something goes wrong, the charges come fast and furious.
Thank you for the information. I wonder if they insure Texans?🤪
Great read- I’ve gotta ask the question here… why was the health plan brought into this. In your explanation of the back injury - she pulled her back moving a child- seems like a workers compensation situation and not a health plan as the injury resulted while under control of the employer.
Thoughts?
workers comp denied--appeals are a long process
Probably picked up her own kid or relative. I don’t think teachers are often physically moving kids at school.
Preschool Special Ed teachers pick up little kids with disabilities.
It would be helpful if this post had told us on what basis United said they were denying the surgery. What alternative treatment did they recommend? Nowadays, there are a number of minimally invasive disc procedures - ? less expensive than traditional laminectomy. That said, private health insurance and its obscene profits and inefficiency have long been killing US healthcare and needs to go away. Single-payer coverage is the best solution. Please check out Physicians for a National Health Program and join the cause!
Thank you! I'm a member myself--just another concerned elderly citizen, not any medical pro. We are up against a King Kong of healthcare greedy CEOs.
To not even suggest another procedure, not give actual reasons for this denial, it's clear as day this decision is all about corporate greed.
I recently read that Wall Street bankers have advised CEOs on these healthcare insurance companies that they aren't pulling in enough profits lately and warned them they need to do more.
What do you think that means for the poor patients all involved?
Biden hasn't done anything to correct this trajectory from mostly Felon 45's plan of moving everyone on TM to MA plans. And I certainly don't hear Harris even talking about it. Democratic party leaders have plenty to worry about currently, but that has to change.
And none of this matters if Rethuglicons steal power, again, in November.
On the off chance that Robin is reading this blog post, I recommend this action from Propublica.
https://www.propublica.org/article/find-out-why-health-insurance-claim-denied
This is really great info, thanks for sharing
I have United Healthcare as my supplemental insurance with Medicare. I have never had a problem. I have had knee replacement surgery, hip replacement surgery and a fractured hip that was repaired. Medicare payed and United Healthcare paid the difference. Something isn't right with this. I think there is more to the story
A dedicated Special Ed teacher should not have to remain in pain when a standard surgery would allow her to continue serving her community. UHC needs government oversight to curb their abhorrent practices. I wish Robin well and hope she gets the care she most assuredly deserves.
Too much information missing from this article to jump to conclusions. I find it interesting they never mention the reason for denial 3 times. That’s a big part of it. Also sounds like it should be workers comp if it happened at work. What else has been tried or have they said surgery is the first option? If she is self insured she should be contact HR and the benefits department, if it’s being denied it’s due to the plan she is in and the benefits chosen and HR/Benefits can decide to allow it.
I can certainly relate to this. This exact situation has happened to me. United Healthcare is the worst at paying when needed and they definitely deny claims that the medical doctor and team deemed necessary. I’m definitely gathering all information needed and speaking with a lawyer concerning them not wanting to approve and cover medical surgeries and procedures recommended by a medical doctor. They eventually approved my surgery, however, I had to go through hell and high water to get it approved FINALLY. 😏😩 I do not recommend United Healthcare to anyone as they don’t mind deducting their money from your paychecks weekly but don’t want to cover medical procedures recommended by your doctor.
Ms. Ginkel is 43 and not on medicare nor medigap. Most of these comments do not apply here. United is 5th wealthiest corporate entity on the fortune 500 and has the 10th largest revenue globally. How do we think they made their billions in health insurance? On denying care for millions of policy holders like Ms. Ginkel!