Near the end of 2009 I went online to medicare.com to compare the Medicare Advantage insurances in my area. I switched from ConnectiCare to AARP Medicare Complete. In February I went for my yearly physical along with a blood test. In April I got two Explanation of Benefits from AARP Medicare Complete which were confusing, so I called up. Total Patient Cost on the Explanation of Benefits was $21 on the physical due to a tetanus shot. Total Patient Cost on the Explanation of Benefits was $0 on the lab blood work.
About week later in April the lab sent me a bill for $212.75. I called AARP Medicare Complete and the lab back and forth FIVE times. Neither one could agree on what I owed. Neither billing department wanted to call and talk with each other to straighten this out.
The various five AARP Medicare Complete representatives told me this: the lab codes were wrong and the lab needed to call them to straighten it out. AARP Medicare Complete pay lab cost ALL the time. The lab should resubmit the bill. I should not pay this bill, I only owe a $10 co-pay. The lab was "balance billing" me which is illegal and the lab should write off the balance.
When I asked on the fifth call what I should do about this bill because the lab refused to call the provider number I had given them, insisted they were not balance billing me and that I owed them the $212.75, I was told by AARP Medicare Complete that I should put my foot down and tell the lab that if they wanted to get paid they should call AARP Medicare Complete and resubmit the bill.
I had also called the lab five different times. I told them to use the provider number and call AARP Medicare Complete and they refused. I told them I was told it was a matter of wrong codes. And I was told by the insurance company, if they called them, it could be straightened out. The lab said the codes were the right ones according to what my referring physician from my routine physical had put down. If the physician had put down that the blood tests were because of a headache or cholesterol, they would have used different codes.
They said I should try to have the physician or even his office staff call them and resubmit the order for the blood work so they can change the code and resubmit it. They said that they weren't balance billing because the insurance company rejected the other codes and nothing was paid on the bill except $3 for venipuncture. They wrote off $23 for the venipuncture. They said I am responsible for the remaining $212.75.
I said last year with Connecticare, a Medicare Advantage insurance, I didn't have to pay anything for the lab blood test after my physical right before I had my cataracts removed. AARP Medicare Complete was also a Medicare Advantage insurance. They said just because they're both medicare advantage programs, doesn't mean they pay for the same things.
So now I am very frustrated with AARP Medicare Advantage for not paying, for putting me in the middle going back and forth between the lab and insurance representatives, for not coming out and telling me what I owe, for having a 'no call' policy and not contacting the lab and settling this with the lab. I'm also frustrated with the lab for not calling the provider number and working this out with the insurance company.
I have to warn everyone that comparing the online medicare advantage insurance companies at medicare.com is not good enough. I got caught by surprise this year, but next year I will be more careful and know what to look for when I go shopping for another medicare advantage insurance company. I will insist on seeing the whole plan information booklet and also Google the insurance companies to see what kind of feedback I get from people who had used them.
I sat here typing this as I watch my mother suffering near death as this company continues to block her from receiving the life saving procedure she needs. She accepted this policy as a supplement to her Medicare insurance as a means to cover what Medicare would not. The representative of this company specifically told her that this was a supplement and would not affect in any way her Medicare coverage.
Now that be said, here is what has happened thus far. She has been denied any medical services because of this insurance's refusal to cover anything even with their own "Approved" medical facilities and doctors. Plus they have completely blocked her Medicare coverage as they have had all Medicare claims routed through their offices. They have had her Medicare coverage blocked and therefore she cannot even see her family doctor at this point.
Even though we have continued to call and demand we she be removed from this program that have either told us that she cannot or they will not remove her. Furthermore she has been either hung up on or talk to in a very abusive and cursive language each time. After finally being told that the only way to be drop from this was a signed letter from her telling them to drop it, she promptly wrote this letter and we both faxed it and mailed one to the company.
So everything you would think is OK, well no. they still refuse to remove her from the program and continue get this. Have been billing Medicare for services that have never even been provided. In short, this is nothing more than a "Huge Scam" by both AARP and Secure Horizons. Yes, I did say AARP as well because AARP is the primary company who is behind Secure Horizons Insurance Group.
This so-called plan was to be only an RX supplement originally, but without either her consent or knowledge they bumped it up to a full medical coverage plan which effectively blocks any and all Medicare coverage because as a HMO all medical procedures and billing must first be sent through them and they in turn bill Medicare.
Through a lawyer (yes we've had to get one), we have found that this way, they can re-bill Medicare extremely high rates for care and procedures done through their non-existent doctors that she has never even seen before. Another catch - every time we've called their 1 800 number after being hung up on and calling back, the number was suddenly discontinued and no longer in service. It took calling from 2 separate phones to continue to try to get this company to drop her coverage.
In the end all it took was a 2 minute phone conversation with a Medicare representative to remove them from her coverage. I afterward called SH back to inform them that she was removed and fill a complaint to no avail. They immediately tried to re-enroll her back on their plan but was themselves block by Medicare.
In the end this company is nothing more than a giant "SCAM" which though a separate entity from AARP, is still a subsidiary company of AARP themselves. I will admit that AARP has been great towards my mother for over 20 years. But then again we have never had to use any of their so called services before. As long as they got their membership dues every year, they were more than happy to offer all these "wonderful" offers from these companies that were "Cohorts" in their schemes to take from the old and poor and make their pockets thick with riches.
All I can say for the elderly & poor is "BEWARE!" Secure Horizons & AARP is nothing more than a scam. If you do not believe me just do your own research either in claims filed against them or on the internet. There is more than a few on both these (well this) companies. If you're elderly and on Medicare or Medicaid, PLEASE all you have to do is call them or go to their website, a government site and set up your own coverage with them. Don't be scammed by these out for your soul companies.
My husband and I enrolled in AARP Medicare Supplemental insurance plan "N" effective December 1, 2010. This has been a nightmare for us. First, we did not receive our cards before December 1st. When the cards arrived there were misspelled name on mine and incorrect addresses on my husband's. I called to let them know of my misspelled name and that my husband had not received any information. Also told the agent who sold us the insurance.
It took several calls and each time I have been reassured that my name is spelled correctly. However, I have never received cards with correct spelling. My husband also keeps getting mail with an incorrect road name. I cannot tell you how many cards and pieces of mail we have received. Too much to keep up with and half of it with incorrect names and road name incorrect.
Also, there was an issue with our drug coverage between eligible for Medicare and when we went primary since I did not retire until older and was both covered under company insurance. This was answered on the enrollment form. Another came in the mail questioning this. I completed and returned the form the next day. About 10 days later I got another "2nd notice" in the mail. I telephoned and spoke to a nice lady who took my call and corrected the information on both our information.
About 5 days later I received a final notice. I called again to have this corrected. This person would not take the information for my husband until I went and found him to tell her this was correct. She promised me a form for him to sign for me to speak. Later on another call this happened again, and again I was promised a form for him to sign for me to do business for him. This form finally came last week. These calls I did not time, except one and it took 45 minutes.
Enrollment has been a nightmare for us and is not rectified to our liking to date. The person with the Rx plan said she told her supervisor and the supervisor was to file a "complaint on my behalf" for whatever good that does. The real concern is that if AARP Medicare Supplemental Insurance plans cannot enroll clients any better than us, how will the claims handling go? I have grave concerns.
LACEY, WASHINGTON -- My wife and I moved from Arizona to Washington on August 3rd, and I began trying to find a physician due to my health problems. I was informed by several pharmacies and doctors I called that no one in Washington recognizes Secure Horizons. I called my insurance company, AARP Medicare Complete, and after a half-hour wait, I was told that Washington was in another section. So I had another 18 minute wait.
They took all the information, and said I was now signed up. A few days later, I received a card in the mail that had a primary care physician's name and phone number. When I called it, I was informed that the doctor had no connection with that clinic. I then called AARP Med Com again, and went through the whole rigmarole again. They gave me another doctor's name and number. I compared my new card with my old one, and guess what? With a few minor differences, they were identical. So much for them being two separate entities.
After several days of getting the runaround, I got word the second doctor was not taking any new patients. Now, I am supposed to see a new doctor on the third of October, but he has to contact AARP and get signed into their provider database. I have run out of most of my medications and cannot get any of them refilled, as I have to see my doctor in Arizona. I am not going to go to Arizona to see a doctor.
My wife took over dealing with AARP after seeing how frustrated I was getting. In just a few hours, she was ready to pull out HER hair. I don't think anyone at AARP Medicare Complete, Western Division know what the heck they are doing. I seldom had a problem in Arizona, but my health now is in danger because of the idiocy shown by the people I must deal with up here.
PALM BAY, FLORIDA -- My husband got a letter that our primary care doctor will no longer be in the plan for 2014. I never received a letter for me. We called the doctor and they said they were taken off the list, not them stopping the use of the AARP plan. Called United Health Care and they made an arbitrary decision to select fewer doctors and claim it is to our advantage. NOT TRUE. Also asked questions about other doctors and services and was given the wrong information. Asked for a list of doctors in the plan and was given doctors that I did not see when I did the search. No explanation given.
We aware that most Advantage Plans are doing the same and you don't have much time to figure out other options. Additionally other options are more expensive. I checked all the advantage plans in this area and my doctor is not on them. He states the advantage plans are taking a new approach to managing the providers for the advantage plans, which means they are eliminating doctors and give you a smaller selection. BEWARE. Asked to speak to a supervisor and was told they would call back within 24 hours. Would not give me email or phone number to contact anyone higher up. Have not received this phone call as I suspected.
My husband and I live part of year in Washington and part of the year in California. When we started going to California in 2009, we transferred our insurance to California, which the company told us to do. My husband had no problem. But mine had countless problems. I would get a letter said that I was cancelled, and the next one said I was covered. I wanted the insurance in December 2009 but did not get any coverage until February 2010 and they billed me from either Dec. 2009 or Jan. 2010.
When we move backed to Washington May 2010, I transferred again back. Same year in December, when I transferred to California, that when they told me I owed them $350 for coverage when I was in Washington (which has no premium). I have called and written to them more than 10 times to explained but never got a response, but just telling me that I owe them the money.
In July 2011, they turned me over to collection. I once again wrote them and I got a letter back on 9/13/2011, saying that I owe them the money and told me I was covered under one plan for both California and Washington with one ID # but I had two different ID #s. They said my Washington ID # is not in their record, but I have proof that I have it. Total Incompetence is all I can said.
SALT LAKE CITY, UTAH -- I have AARP Medicare Complete (Group/Retiree Plan which has a prescription component). On my way home from the Dr. I stopped at my local drug store to get prescriptions filled. It seemed to be taking ages and finally the young man behind the counter told me that he couldn't get an OK from United Health care (provider of AARP Medicare Complete). They said there was a block on my card. OK. I was feeling lousy and anxious to start the medications so I went home and got on the phone.
The number the druggist had given me was wrong. Another number provided. Called again. Went through an extensive menu. Finally got a human who informed me that this number also was wrong. I was directed to wrong number after wrong number -- an hour and a half worth. Nobody could tell me why my card was blocked or who had blocked it. Finally, someone determined that it shouldn't have been blocked and told me this would be corrected in 48 hours. 48 hours!!! I needed my prescriptions before then!
Finally, a nice woman called ** got the time frame reduced to two hours but she couldn't tell me why this had occurred in the first place. She told me she'd mail me a complaint form, which I am still waiting for. Compared to other problems I've read about, this is minor. But it was an inconvenience that showed me that their systems are screwed up!
MILTON, FLORIDA -- My husband has pancreatic cancer. After endless hours on the telephone with Secure Horizons, UHC I was asked how many procedures we are talking about. "I said 3 x 52 = 153 procedures". She said "OK 153 procedures" and gave me pre-approval to use procedure code 62360 for my husband. It was explained that this code was exclusively for the procedure. They did not require a code for what goes into it, i.e. if use saline, no code is required.
My husband has been getting his procedure three times each week. UHC paid approximately two each month and denied the rest as "813 included in global package". After several months of endless phone calls, I am now told that they will only pay for this procedure every ten days.
SALT LAKE CITY, UTAH -- I just read a published review by someone who defines and expresses my similar negative experiences with AARP Medicare Complete from Secure Horizons, as well as some of the variable claim agencies they use. When I call the main phone number for Secure Horizons, the representatives are inept much of the time, perhaps because their training is minimal and their information is incomplete, outdated, and often incorrect. I have gotten two different answers to the same question.
They give wrong phone numbers to call (I made seven calls one day to get to Optum Health to verify vision coverage and discuss a claim denial). They show deluxe rider coverage but cannot find even one claim. The database they use is not cross-referenced, and they are not even aware that there are a variety of company subsidiaries controlling approvals and claims for Secure Horizons.
This company really needs to find a way to improve their databases and their helpfulness to their customers. By that I mean, take the customer's telephone number, investigate the matter further with a knowledgeable superior, get specific answers to specific questions, and call the customer back with confirmed and accurate information.
I applied for AARP Medi-gap to pay a premium of $260/month. My mom had some therapy done and 3 months later after getting the bill, AARP comes back denying the claim. They say they determine it was a pre-existing condition; meaning the first 3 months of the plan they will not cover. OK I'll be willing to give them that. The second half of my mom's treatment is purely cost of meds (Medicare part D) so AARP knows it doesn't have to do that.
Later my mom has some simple blood tests done and Medicare only pays $20+ and AARP is supposed to pay the rest. They denied the claim. Zero. Three months of paying $260/month and they wouldn't even pay $90: taking your money and going out of their way to avoid giving any coverage no matter how small.