General Discussion
In reply to the discussion: medicare etc [View all]in2herbs
(2,948 posts)with a medi-gap policy. I don't think a lot of people understand that anything and everything that Medicare offers must be offered in an Advantage plan at the same price that could be obtained through straight Medicare. If you find that your Advantage plan cannot meet this Medicare care requirement you can change plans. For instance, just this week I changed my H's insurance plan because his Medicare Advantage provider did not have any in-home physician care in our area. The new provider begins on March 1, but until then he's still covered under his old provider. I can tell you that the govt comes down hard on Advantage providers who can't/won't meet Medicare requirements. His old insurance provider kept giving me names for in-home physician care referrals but each one I contacted said they didn't service our area even though they claimed to service our zip code. A few years ago, H's soon to be old insurance provider was on a one year suspension for violating their Medicare requirement. They could not write any Medicare policies during that year and before they could get off suspension they had to prove that they could meet Medicare care requirements.
So now the question is did his soon to be old insurance provider know that the parties they were subcontracting with could not meet Medicare requirements, or did the subcontractors dupe the insurance company? When I spoke to the Customer Service Center at H's current insurance company she asked if I wanted to file a complaint about this. I said yes and while on the phone she typed out the complaint, read it to me for my approval, and forwarded it to the insurance company legal department. I have a feeling they are all going to be blaming each other. I have already started getting calls from insurance administration officials.
In summary all Advantage Medicare plans must provide the same price and coverage as does Medicare. This does not change state by state. The only difference in the two are the frills such as dental, eye glasses, etc., and what they charge for these frills (RX optional).