A way to save money for the medicare system and

[Bobby17]

tax payers.
Stop making people who have medical insurance thru their work be forced into taking medicare, so the rich greedy insurance companies dont have to pay the bills anymore. This is one of the biggest scams out there. A private for profit corporation gets to subsidize their business with tax payer dollars.

I retired from my job on a disability and have got a good medical insurance policy from my employer, but now blue cross is telling me i have to take part b and if i dont they are only going to pay what they would have to pay if did have it. I have been on ssd for 8 years, so am looking at a 80 percent penalty now. How after 8 years can they pull this govt provision on me? Not only am i looking at a huge penalty but now my great medical plan is going to turn into a piece of crap medicare plan. Medicare should be for people that have no insurance and need help, not people who already have medical coverage. This just isnt right and no wonder the system is going broke. Private business making a profit off tax payers.
Sorry for the rant but i needed to vent and do it a place where other people understand.
I dont know what am going to do because i really need my good insurance do to having lots of medical problems on top of my disability. Am considering just giving up my ssd all together, then they cant touch my insurance plan.
If anybody has any ideas please chime in
Thanks
Bobby

[keithy02]

but if you would have had it together you would have taken medicare in the first place and used your ins comp for supp
all of you take a lesson here to do your home work and be informed
sorry but always know all the rules
smile keith :):):)

[cferro514]

Hi Bobby,
I would just pay, if your insurance is being paid by your former employer. Medicare Part D is not cheap, and you will have to find a plan to cover all your meds.

I had to take Medicare Part B when first eligible to keep my Blue Cross, as secondary coverage.
My plan cover Meds, and I get a letter each year telling me I do not have to take Medicare Part D.
You need to ask your insurance company about this wavier statement.

[Bobby17]

Guys, you missed my point. If it wasnt for the politicians being in bed with the insurance companies, laws like this would have never been passed. Think about it why should you be fofced into taking another insurance when you already have a good policy. Its criminal that the insurance companies are getting to subsidize their business with tax payer dollars, downright disgusting.

Keith as far as taking it when i was first eligible. My union contract states i dont have to take medicare part b until am 65 and blue cross has always honored that, now after 8 years they are saying no.

No i dont need to take part


So guys did your blue cross policy remain the same or did they give you a whole differnt plan? Also i heard if medicare doesnt cover a procedure, then blue cross doesnt either. Is that true?

Thanks for the help
Bobby

[echoes long ago]

I agree with you Bobby. My medical coverage is less after having to take medicare instead of the standard medical insurance my job offers. My family has better benefits than i do with less co pays and I am the one who is the primary on the insurance. They have it because of me.

[Bobby17]

I agree with you Bobby. My medical coverage is less after having to take medicare instead of the standard medical insurance my job offers. My family has better benefits than i do with less co pays and I am the one who is the primary on the insurance. They have it because of me.



Totally agree. I dont understand why your policy is allowed to be downgraded with less coverage. This is just flat out wrong and its time the politicians in this country correct this problem, instead of taking their kickbacks from the insurance companies for passing these kinds of laws. When a person becomes injuried, now is when they need the good medical policy, not less of a policy.
I can see am probably just gonna have to give up ssd and instead keep my former employers medical insurance.

[fredk]

I know you want to blame politicians for this but I would suspect that in actuality the contract between your former company and the insurance company has changed.

Try calling both and ask why after 8 years they are now requiring you to take Medicare.

[Bobby17]

I know you want to blame politicians for this but I would suspect that in actuality the contract between your former company and the insurance company has changed.

Try calling both and ask why after 8 years they are now requiring you to take Medicare.


the politicians are the ones who passed the laws making everybody have to take medicare even if they have their own insurance. This is so the insurance compnaies can collect the moeny for the policies and not have to pay the bills. Medicare should be for people who dont have private insurance, not for people who have good private medical plans.
The politicians being in bed with the insurance companies is what caused this to happen.

[fredk]

If nothing has changed then why after 8 years are they now requiring you to get Medicare ?

If the big bad insurance company could have done this all along why didmt they ?

[Bobby17]

If nothing has changed then why after 8 years are they now requiring you to get Medicare ?

If the big bad insurance company could have done this all along why didmt they ?


Are union contract said that we didnt have to take it until we reach age 65 and for the last 8 years they have honored that, but now they are quoting the govt law that we must take it. In fact the guys on the job now have it in their contratcs that they must take it at whatever age they become eligible. Maybe since its been 8 years, i could win based on being grandfathered in, dont know.

So Fred since you seem to like the insurance companies, let me ask you.
Do you think its right if a person has a private medical insurance policy, he has to be forced into taking the govt medicare plan? You actually cant see that the insurance company gets to collect the money for peoples policies while not having to pay out on the medical bills due to medicare paying first.
You actually think tax payers subsidizing a private for profit corporation is okay? How do you think this happened? The politicians passed the laws doing this, for those big bad insurance companies.
You should not be forced into a govt plan, if you dont need one.

[fredk]

I have a couple questions for you.

How old are you ?

How many employees does your old company employ ?

Are you retired , diabled, or both ?

[Bobby17]

I have a couple questions for you.

How old are you ?

How many employees does your old company employ ?

Are you retired , diabled, or both ?


46 retired with a disability retirement. Got a neck injury on the job.
Former employer was the city fire dept. City probably has 600-700 employees.

I think i know where your going with this. I know all about the govt rule. That rule was passed to help insurance companies, which is not right.
Why should i get treated differntly then a regular retiree? I get less of a medical policy for doing my job and getting hurt? This just isnt right.

[fredk]

Per Medocare rules if you are retired and covered by both Medicare and private insurance from a company that employs over 100 employees Medicare is secondary to your private insurance.

Your coverage shouldnt change but you will be able t file any deductibles or copays with Medicare.

These rules are in place to protect small companies and their employees. Can you imagine what would happen to small plans of just a few employees if just 1 or 2 of those employees became disabled and the small employer plan had to be primary ? If a company has fewer than 100 employees then Medicare becomes primary. If company plan was primary then rates would skyrocket and these companies would wind up cancelling their plans.

[Bobby17]

Per Medocare rules if you are retired and covered by both Medicare and private insurance from a company that employs over 100 employees Medicare is secondary to your private insurance.

Your coverage shouldnt change but you will be able t file any deductibles or copays with Medicare.

These rules are in place to protect small companies and their employees. Can you imagine what would happen to small plans of just a few employees if just 1 or 2 of those employees became disabled and the small employer plan had to be primary ? If a company has fewer than 100 employees then Medicare becomes primary. If company plan was primary then rates would skyrocket and these companies would wind up cancelling their plans.



Fred, little confused. Why would companies with less then 100 employees fold is blue cross plans stayed the primary, instead of medicare? Company is already paying blue cross for the plan. Looks like the only people making out, is the insurance company because they get to collect the premium from the employer for the employee plan, yet they dont have to pay the bills medicare does.

Also why are they telling me that medicare has to be my primary then?

Thanks for the help

[keithy02]

right away no co pay what ever medicare does not pay my union
supplemental picks up so i pay nothing
hope yours workes like that if not i would *****
smile keith:):):)

[Bobby17]

right away no co pay what ever medicare does not pay my union
supplemental picks up so i pay nothing
hope yours workes like that if not i would *****
smile keith:):):)


Keith,
Is your union plan that you are getting the same plan a regular retiree gets or did you lose things in your plan? Like did you have any riders taken away.
Also do you need to get referrals with medicare in order to go to doctors? The way my plan is now, i can go anywhere i want without a referral.
thanks for the help

[-Mimi-]

I worked in Employee Benefits for over 20 years before I became disabled. 95% of insurance plans state in the plan document that Medicare is primary and their plan is secondary UNLESS the employee is actively at work. Then the plan is primary with Medicare secondary. This would mainly apply to an employee's spouse on Medicare. The company I worked for had over 20,000 employees world wide and the plan document clearly states Medicare is primary. I have seen this in MANY cases. It isn't always the insurance company that makes that decision, it is the employer when the plan is set up that decides it. They look to save claims dollars which keeps the premium down so they prefer Medicare is primary. Bigger employers are usually self funded which means they pay an administrative fee to an insurance company and pay the claims (with stop loss protection against large claims). More than likely your government plan is self funded with that many employees. When self funded, you see more exclusions and limitations within the plan to keep the claims cost down for the employer.

Bobby, you should be protected by the union and need to file a grievance with them.

[Bobby17]

I worked in Employee Benefits for over 20 years before I became disabled. 95% of insurance plans state in the plan document that Medicare is primary and their plan is secondary UNLESS the employee is actively at work. Then the plan is primary with Medicare secondary. This would mainly apply to an employee's spouse on Medicare. The company I worked for had over 20,000 employees world wide and the plan document clearly states Medicare is primary. I have seen this in MANY cases. It isn't always the insurance company that makes that decision, it is the employer when the plan is set up that decides it. They look to save claims dollars which keeps the premium down so they prefer Medicare is primary. Bigger employers are usually self funded which means they pay an administrative fee to an insurance company and pay the claims (with stop loss protection against large claims). More than likely your government plan is self funded with that many employees. When self funded, you see more exclusions and limitations within the plan to keep the claims cost down for the employer.

Bobby, you should be protected by the union and need to file a grievance with them.


Mimi, What kind of grievance should i file?
In the medical contract that i retired under which is an old contract, it just states that when an employee reaches 65 they must take medicare part a, not even part b, just part a. There is no reference to what happens if a person gets hurts and retires before medicare age. In fact 2 years ago the city rewrote the contract and it now clearly states that you must take medicare at whatever age you become eligible for it.
So for 8 years they have been honoring the contract and not asked me to get part b, now they say i must get part b even thou theres now an 80 percent penalty. Also under my retirement iam supposed to be treated exactly the same as a regular retiree, which if they force me into part b before i turn 65 am not being treated as a regular retiree.

Mimi, how is it they are also able to downgrade your policy? Even if you are indeed forced to take medicare, shouldnt your backup policy remain exactly the same as it was before taking medicare?
Thanks for the help

p.s. almost forgot. So if the city made a contract with blue cross that its employees didnt have to take medicare when they are eligible, does that then cancel out the govt rule that says you must take it when you become eligible? Is the deal that blue cross and my city made, the final say? Like i said in the new contratc for guys on the job, the city worded it in there.

[-Mimi-]

Bobby, because you are a retiree under an old contract, that is what they are obligated to continue you under. You need to discuss this with your union representative. They can guide you on the grievance policy. We had MANY different union contracts we had to administer and it was a nightmare for us. We couldn't change them because it is what was negotiated with the union. Employees under prior contracts like these can't be penalized with the newer contracts. We had a rule of thumb, if it wasn't specifically stated in the document that something wasn't excluded, or in your situation that you must take medicare, then it must be paid. I am sure that is why the verbiage was included in a later contract.

A plan can be changed annually and is pretty common. They are under a one year contract with the insurance company and if the rates rise more than was allocated in the budget, they rework the plan. Some of the biggest changes common are the deductibles and out of pockets being higher. These offer the biggest discounts in premiums. An example, when I started with my employer, I had a $10 copay, $100 deductible, 90% coinsurance, $500 out of pocket maximum and low copay drug card. My company now has a $400 deductible, 80% plan, no copay and a $3,500 out of pocket. There isn't anything employees can do because the employer is offering coverage. The only protection is the union. If the contract was negotiated with certain benefits for the duration of the contract, then benefits cannot be changed.

[Bobby17]

Bobby, because you are a retiree under an old contract, that is what they are obligated to continue you under. You need to discuss this with your union representative. They can guide you on the grievance policy. We had MANY different union contracts we had to administer and it was a nightmare for us. We couldn't change them because it is what was negotiated with the union. Employees under prior contracts like these can't be penalized with the newer contracts. We had a rule of thumb, if it wasn't specifically stated in the document that something wasn't excluded, or in your situation that you must take medicare, then it must be paid. I am sure that is why the verbiage was included in a later contract.

A plan can be changed annually and is pretty common. They are under a one year contract with the insurance company and if the rates rise more than was allocated in the budget, they rework the plan. Some of the biggest changes common are the deductibles and out of pockets being higher. These offer the biggest discounts in premiums. An example, when I started with my employer, I had a $10 copay, $100 deductible, 90% coinsurance, $500 out of pocket maximum and low copay drug card. My company now has a $400 deductible, 80% plan, no copay and a $3,500 out of pocket. There isn't anything employees can do because the employer is offering coverage. The only protection is the union. If the contract was negotiated with certain benefits for the duration of the contract, then benefits cannot be changed.


Mimi, Thank you very much for the help, your really starting to make me feel alot better. So the govt rule cant trump the deal blue cross and the city made with each other? Because this is what the insurance company is using on me.
thanks again