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A caregiver rants about insurance company communication

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I’m an easy-going sort usually, so why do I find it so hard to keep my temper when I’m talking to customer service reps at insurance companies?

Case in point: A week or so ago, out of the blue, Pops got a letter from Aetna welcoming him to the Aetna Medicare Rx Plan – except nobody had ever enrolled him in the Aetna Medicare Rx Plan. The letter was full of irrelevancies and was unhelpful in explaining why he was getting it. I told him I would call Aetna and find out what was going on.

I did remember that last year the EPIC New York State Prescription Plan, in which Pops had been enrolled for years, required him to sign up for a Part D prescription plan and provided a list of alternative plans. At that time, I called and talked to the EPIC rep and picked a plan called RX1 administered by a company called Simply Prescriptions. That is the plan he has been using. So where the heck does Aetna come in?

So I called Aetna and the rep said the computer showed that he was enrolled by “beneficiary selection.” I said no one had ever enrolled him in Aetna, and the rep said the record showed someone had, so the conversation had reached an impasse, and I felt that familiar first sign of my temper flaring up (my ears get warm – and maybe red too, but I can’t see them).

So I called Simply Prescriptions and the customer service rep there said Pops was still enrolled and that if he was enrolled in Aetna too, and Medicare found out, they would cancel all his drug coverage until the problem could be sorted out. This sounded a little bit alarming.

I decided to go to the top, so I called Medicare. The customer rep there said the record showed that Pops was being covered by Aetna, not Simply Prescriptions. Like the Aetna rep, he said somebody had enrolled Pops. No, I said no one enrolled him in Aetna. If someone did, it would have been me, and I didn’t. I suggested that maybe EPIC switched his drug coverage to Aetna without our knowledge.

“It says here it was ‘beneficiary selection’,” the Medicare rep said.

I sputtered something about how these letters from insurance companies come out of the blue, and never give you any background or context and can’t Medicare do something about it. The customer rep said he appreciated my frustration. He even sounded like he meant it.

So I called EPIC, who I should have called first, I guess. The customer rep said that EPIC had indeed discontinued using Simply Prescriptions and moved the program to Aetna to save money. She said that a letter had gone out to members explaining this. (That letter must be under the pile of Publishers Clearing House mailings on Pops’ desk, I thought to myself.)

So we had missed the letter, and it was “our fault”, and I had to recalibrate my anger level back to yellow from orange (I use the same color scale as Homeland Security).

But I still don’t understand why insurance company letters to senior citizens can’t explain things in clear sentences and maybe include a little background and context to help people make sense of them. If Aetna had just said “Welcome to former Simply Prescription members” or something like that, it would have been enough. And why would the insurance company records say “beneficiary selection” instead of “transfer of contract” or some other more accurate statement?

Arrghh!

End of tirade.

Take care of yourself.

Jeff

Last Updated:1/10/2008
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Date: 12.12.2018, 23:25 / Views: 95541