Aetna supplemental insurance

Greetings, everyone!
I'm not sure if this thread already exists. If it does, I'd appreciate it if the mods could move it to the right place.

I mostly signed a three-year contract through my union, on a monthly basis. $25 Regarding Aetna.

The Secretary of Health hasn't even signed off on it yet, so nothing is actually happening. Every single one. Going to the doctor, then paying out of pocket at the pharmacy... what a joke. $3.25 Those participation reimbursements they send back once you submit your R1 invoices.

No, what I’m actually trying to get at is— They completely screwed me over.
I went to the local 24-hour pharmacy in my town tonight, only to be told my Aetna card was useless because they don't have a contract with them. Absolutely ridiculous.

So, the guy didn't even bother telling me when he stopped by my workplace—since they’re just *so* incredibly accommodating that they bring products right to your doorstep—to claim they have a contract. It’s only happening at certain pharmacies. Across the USA.

She called me from my cell right away and all she says is: "Can't you just go to a different pharmacy?" Oh, really? Like I suddenly grew a car or realized that you can't pick up prescriptions without insurance coverage. The prices are outrageous. It’s because they haven't finalized contracts with all the pharmacies in Chicago, specifically not even with certain ones. The local pharmacy.!!!!

Well, that's why I have my pharmacy right at the edge of town, over in Brooklyn.

I want to issue a warning to anyone who might be approached by Aetna offering supplemental insurance—you know, those three-year plans they try to push through unions or whatever else. Watch out. They always ask. Which specific medical facilities and providers do they actually have contracts with? I’m particularly interested in which pharmacies are covered—especially in Chicago, since there are only two or three listed on the network.

It’s only once you actually sign the contract, though. They’re rushing to get those documents over to us in two weeks—including lists of hospitals and pharmacies—but they won't tell us which specific providers they actually have contracts with until then.

Basically, at the end of our call tonight, the guy told me I need to request an itemized receipt for my covered medication. He said I should mail it back using their pre-paid envelope—though I’m not about to take that risk and let them claim they never received anything!

I'm planning on calling them tomorrow. If I can't force them to issue my refund, I’m taking this straight to the Better Business Bureau and the local news.

In a word: disgraceful.

Most private insurance providers—anywhere outside of Medicare—already handle things this way. You just pay for the exam or the medication upfront and then file for reimbursement 🤷

Lawrence Cruz said:Most private insurance providers—anywhere outside of Medicare—already handle things this way. You just pay for the exam or the medication upfront and then file for reimbursement 🤷

That’s all well and good if you’re loaded, but if you’re broke, you’re just out of luck.
That is exactly why people get supplemental coverage in the first place.
Give me a break.

stormycyclist53 said:That’s all well and good if you’re loaded, but if you’re broke, you’re just out of luck.
That is exactly why people get supplemental coverage in the first place.
Give me a break.

I am not trying to defend the insurance industry here, but you really should have read the fine print before signing anything.

Supplemental plans are only available through Medicare.

If you have a plan through Aetna, what you actually have is voluntary health insurance 😉

mellowgull80 said:I am not trying to defend the insurance industry here, but you really should have read the fine print before signing anything.

Supplemental plans are only available through Medicare.

If you have a plan through Aetna, what you actually have is voluntary health insurance 😉

Then why does their actual website say "Supplemental insurance"?!

I noticed the last post here was four months ago, so maybe things shifted in the meantime?
Did they fix that shady setup everyone was complaining about, or is that "issue" still a thing?
The promo is only running for another week, so I'm seriously considering jumping on it...

mellowgull80 said:I am not trying to defend the insurance industry here, but you really should have read the fine print before signing anything.

Supplemental plans are only available through Medicare.

If you have a plan through Aetna, what you actually have is voluntary health insurance 😉

Well, even the stuff through Medicare is technically voluntary insurance, since there isn't any law that actually forces you to pay for it.

I’d say calling this Medicare coverage—specifically the $43 part—"voluntary" is a joke, purely because we aren't forced to pay for it. But if you actually look at the classification and how the policy is structured, it’s clearly supplemental insurance. On the flip side, MetLife also claims to offer supplemental insurance, and honestly, it would be a miracle if they actually provided anything extra. I get mandatory coverage, but now we’ve got voluntary, additional, and supplemental thrown into the mix? I have no clue what actually exists, what the real differences are, or which of these two companies is actually providing what they claim... I'm legitimately lost here. I just want something that's "cheap but solid" 🙂. Basically, for $25 what I'm currently shelling out $43, I expect results. If it's not the same thing, the deal is off 🙂. It'll probably cost me more running all over town trying to find a pharmacy that actually works and chasing down receipts from these companies that rigged the whole system than whatever the price difference is anyway.

Just a heads up, MetLife isn't actually part of State Farm... they're more like brokers or an agency that works with all sorts of different providers. Honestly, I always think it's better to just go straight to the source, you know? Like, deal directly with the main company so you get the full scoop instead of going through some random third-party website or middleman...
Everyone ends up paying those copays, unfortunately. It’s like the government tries to be clever by not recognizing certain supplemental insurance cards everywhere, which is such a pain... but on the bright side, you can usually get reimbursed for every single one. You just take your receipts, pop them in an envelope—don't worry, you don't have to pay for postage—and mail them back to the home office, or just drop them off at the nearest local branch where you have your policy...

Peter Perez66 said:I’d say calling this Medicare coverage—specifically the $43 part—"voluntary" is a joke, purely because we aren't forced to pay for it. But if you actually look at the classification and how the policy is structured, it’s clearly supplemental insurance. On the flip side, MetLife also claims to offer supplemental insurance, and honestly, it would be a miracle if they actually provided anything extra. I get mandatory coverage, but now we’ve got voluntary, additional, and supplemental thrown into the mix? I have no clue what actually exists, what the real differences are, or which of these two companies is actually providing what they claim... I'm legitimately lost here. I just want something that's "cheap but solid" 🙂. Basically, for $25 what I'm currently shelling out $43, I expect results. If it's not the same thing, the deal is off 🙂. It'll probably cost me more running all over town trying to find a pharmacy that actually works and chasing down receipts from these companies that rigged the whole system than whatever the price difference is anyway.

The root of the issue is that insurance agents don't explain things well enough to their clients, and clients really ought to do their own homework beforehand (though not everyone has the time or the knack for digging through websites).

I had an awkward encounter with a patient who hadn't been explained things properly, and she ended up making quite a scene at the pharmacy.
It took a lot of patience and tact to show her that she simply didn't have the right information.
She apologized later. 😉

Here’s the breakdown:

Medicare $43per month for those with higher salaries $1700
covers the co-pays for prescriptions, doctor visits, specialists, lab work, and hospital stays... but it doesn't cover the extra out-of-pocket cost for drugs that are on the specialty list
. Basically, you have to pay the difference yourself, and nobody is going to refund you .
If you use medications from that list, check here and run the math:

http://www.medicare.gov/specialty-drug-list

If you have FDA Supplemental Insurance then everything is covered , though you might not be able to apply it directly via your card at every single medical facility; sometimes you pay upfront and then file for reimbursement.
As for the co-pay $3.25per prescription, Medicare has an agreement with the FDA, so most pharmacies can process it easily. You just provide your info and you don't have to pay that $3.25.
But if there's a drug surcharge and the pharmacy doesn't have an agreement with the FDA, you'll end up paying the full amount, and you won't get that $3.25/prescription back immediately.

List of facilities

http://www.healthinsurance.gov/supplemental-coverage-info

Essentially, you get a full reimbursement for FDA Supplemental Insurance.

"Additional" insurance is something else entirely.
It grants you rights to specialist visits or herbal remedies covered by your specific policy.
There are various types of additional policies with different prices and service ranges. I think it's mostly geared toward people who want faster access to specialists or a bit more comfort during exams.

http://www.healthinsurance.gov/optima-plan-details

What's bothering both of us is where the catch lies 😕

I called the FDA and asked them what kind of sense it makes for an insurance company to offer this policy.$25/mo if a patient has to pay a copay for drugs on the supplemental list, say $100/mo (it happens).
The way I understood their response was that they're basically assuming people who don't spend anything at all end up with much more in their pockets. That’s just my take on what they said, though.😁

Bottom line for me? It’s a total no-brainer to go with the FDA plan, especially once you factor in the necessary reimbursements.
You get much broader coverage for $18 per month.
Look, I'm just not going to keep paying Medicare $43/mo.
My only real expectation is that they step up and offer a product that can actually compete with what the FDA provides.

If anyone has specific questions about how to actually use an FDA card, I’ve got a little energy left to answer them—even if I am currently gearing up for my summer vacation.😉

Just to be clear, I have zero ties to the FDA. This isn't an ad or anything; it's just observations from someone who works directly with patients and holds a contract with the FDA.

Peter Perez66 said:Then why does their actual website say "Supplemental insurance"?!

I noticed the last post here was four months ago, so maybe things shifted in the meantime?
Did they fix that shady setup everyone was complaining about, or is that "issue" still a thing?
The promo is only running for another week, so I'm seriously considering jumping on it...

Looks like they might've changed things up, but honestly, I haven't dug deep into their current lineup.
It’s totally possible they’re offering supplemental coverage now—probably just some desperate move because of the economic 😁 slump before a potential buyout...

Here’s a quick breakdown of how using your Medicare card actually works

I’m not sure what kind of confusion you guys are talking about. Before July 15th, the process was pretty straightforward: you’d either pay your copay at the pharmacy or to the doctor, then just send over the original receipt, and they’d reimburse you directly into your account right away. If you were at the hospital, it was even easier—you didn't have to pay anything upfront at all.

Since July 15th, most pharmacies have started stocking those card readers for the FDA, so it shouldn't be an issue anymore. If you happen to run into a spot that doesn't have one yet, just go ahead and pay out of pocket, and they'll refund you immediately. Or, you could always just call their toll-free number to ask which nearby locations have the equipment ready. Since this change only went into effect on July 15th, I'm guessing not every single place has caught up yet—like maybe some of those smaller independent pharmacies.

So, I finally signed up for FDA coverage today, and I spent basically my entire afternoon just staring at my inbox waiting for a confirmation email.
It’s been total chaos over there—they aren't picking up the phone either, and I kept getting a busy signal every single time I tried to call.

edit
Well, the confirmation finally popped up after an eight-hour wait, which is funny because the coverage actually kicks in in just a few minutes.
If anyone else is out there stressing about the same thing, just hang tight. It’ll show up eventually.

I attempted to purchase supplemental insurance through MetLife today, but I am unable to complete the payment via online banking. Every time I try, the system returns an error stating the reference number is incorrect. I have carefully entered both the model and the reference number provided in my email, and I even verified my Social Security number, yet it still fails. Has anyone else encountered this specific issue? 🙂

To be honest, I'm really not sure—I just put it on my credit card.

just type 99 00 into the model instead

"Quote:"

Timothy Roberts said:I attempted to purchase supplemental insurance through MetLife today, but I am unable to complete the payment via online banking. Every time I try, the system returns an error stating the reference number is incorrect. I have carefully entered both the model and the reference number provided in my email, and I even verified my Social Security number, yet it still fails. Has anyone else encountered this specific issue? 🙂

"Quote:"

Scott Alvarez4 said:just type 99 00 into the model instead

Same here—I was getting that same error at exactly midnight. 🙂

"Quote:"

swiftbear86 said:So, I finally signed up for FDA coverage today, and I spent basically my entire afternoon just staring at my inbox waiting for a confirmation email.
It’s been total chaos over there—they aren't picking up the phone either, and I kept getting a busy signal every single time I tried to call.

edit
Well, the confirmation finally popped up after an eight-hour wait, which is funny because the coverage actually kicks in in just a few minutes.
If anyone else is out there stressing about the same thing, just hang tight. It’ll show up eventually.

So, does that mean I don't need to worry?

Just check your user profile to see if the transaction status shows as completed.

I set everything up back on August 2nd. Fast forward to today, August 21st, and my policy and ID card finally showed up at my doorstep. Turns out they’re valid from August 15th, 2013, through August 15th, 2016.
Payments are due on the 15th of every month—I can just use the slips they sent or handle it via online banking.
This was for a three-year premium plan.$900
Once this contract runs its course, I'll have to do some digging to see which GEICO plan actually offers the best bang for my buck.

Hey, just a quick, slightly silly question since I'm stuck at work and don't really have the headspace to go digging through Google right now 🙂 so, I see they're actually extending the promotion, which is great, but I was wondering about a couple of things: 1. Are you signing up for the full three years right out of the gate?? and 2. Is it that $75 monthly thing, or are they expecting you to cough up the whole amount upfront?