Friday, June 21, 2013

Universal Healthcare Bankruptcy or How Medicare and CMS Screwed Up

This is an opinion piece on the untimely demise of the Medicare Advantage program.

Turning sixty five does have some perks and comprehensive medical care is one of them. Now, Social Security isn't a money making deal for some of us, but it does help seniors get by with a little dignity. Unfortunately, that's not the case IMHO with today's Medicare program, especially when the program fails you.

Early on this year, my wife, a medical insurance agent received word through her agencies management that the Medicare Advantage program we'd signed up for, Universal Healthcare was facing difficulty in Florida and was on the verge of bankruptcy. The confusing communications sent to her instructed all agents to begin contact with their Universal clients and divert them to other plans before the demise of the company.

I contacted Medicare directly and they assured me that Universal Healthcare in Texas would not be affected and that our plan was in force. Boy, was that wrong.

Now, from what I read, a transfer couldn't be done until CMS notified Universal Healthcare clients in writing that they had a special election to transfer. That came at the last minute late in April, and didn't allow enough time to transfer to a program of choice. Instead, CMS automatically transferred everyone to original Medicare and Cigna Medicare Rx. This immediately caused problems with our coverage in that Universal Healthcare offered a prescription service at no cost. Cigna's plan had a monthly fee of $31.80 with a $300.00 yearly deductible. Unfortunately, there was no way we could have satisfied this deductible in the calendar year with our medications, so in a sense Cigna would receive free money with no obligation to pay anything to us in return.

Realizing the disparity, I sent out a letter of complaint to CMS and it reads as follows:

"I was informed in late April of this year that my Medicare plan with Universal Healthcare was terminated and that CMS assigned me to regular Medicare and Cigna Medicare Rx. I was also informed that I had two months to transfer to another program. My complaint concerns the involuntary assignment to a prescription plan I didn't want and that I was assessed a $31.80 monthly charge for this service. I did not want this plan nor do I have any intention of paying for a service I did not request. I've contacted Cigna, but they refuse to delete this charge from the account CMS created for me. It is now my intention to contact the Texas State Board of Insurance and complain to them about this disservice generated by CMS. I would appreciate it if CMS, Medicare or some entity at your end could aid me in this request."

Needless to say, nothing has been accomplished to date even though CMS followed up with a phone call about the complaint. I was informed that the bankruptcy judge declared all Universal Healthcare plans in all states bankrupt. CMS had little time to act, and when they did, saddled the policy holders with the worst possible coverage available. In my opinion, CMS let down an innumerable amount of seniors by acting in haste, hurting the very people they are sworn to protect.


I was contacted today by a representative of Cigna HealthCare and advised that, in their opinion, this entire mess is the responsibility of CMS. Their position is that the process many seniors suffered through is valid and that their company is due the $31.80 assessed to thousands. They do not see CMS admitting their fault and dis-enrolling anyone retroactively. This is sad and a disservice to seniors.

I've contacted both Texas Senators and have provided them with this information in the hopes that they will come to our aid. My request to their office was to ask themto fight for their senior constituency and pursue the possibility of doing what CMS will not do at this time. Allow all those who have complained or not to dis-enroll retroactively from the Cigna plan and force the company to stop billing for a service that was not wanted or requested. It's a shame we seniors will be subjected to collection agencies and credit ruin for something we had no control over.