Showing posts with label Medicare advantage. Show all posts
Showing posts with label Medicare advantage. Show all posts

Tuesday, August 30, 2011

Things were going so well, and then...

My friend Jessica has been gushing all over Facebook for months about a barbecue joint called Oklahoma Joe's.  The more she talked about it, the more I wanted to try it.  Problem is, both locations are an hour away from us, on the Kansas side of the Kansas City metropolitan area.  I have suffered in silence all this time, but yesterday I broke the news to Cliff that I simply had to eat at Oklahoma Joe's to see what I was missing.  
So today, we went.  The Kansas City, Kansas, location is ten miles closer, but the Olathe one seemed like more of a direct route; the GPS gave the same travel-time to get to either one.  We chose Olathe.
We arrived around 11:30 A.M. to see a line of people that reached almost all the way to the entry door.  They have a very good system, though, for moving people along; so we weren't standing long.  I got the Z-man sandwich my friend recommended; Cliff got a barbecue plate of sausage and brisket, with a side of beans.  
We both loved the food.  The regular barbecue sauce was as good as any I've had, and Cliff agrees.  He tried the hot sauce; I took a tiny taste, but it was really too hot to suit me.  Even Cliff, who likes hot, spicy seasoning, preferred the regular sauce.  
When we left I was fulfilled and happy.  We'd never drive that far again just to eat at Oklahoma Joe's, but if we were passing through to visit my brother-in-law at Elk City, Kansas, or if we were on our way to Colorado or points farther west, I'd pick up another sandwich like the one I had today.  
We found a Dairy Queen and got a mini-blizzard for dessert, then stopped by the Walmart in Oak Grove to get a couple of Cliff's prescriptions and some groceries.  That's where my mood changed.
Medicare Complete wouldn't pay for our prescriptions; they wanted us to submit to our "other" insurance.  
We haven't had any other insurance since Cliff retired!  And it seemed strange that they paid for the prescriptions we got for Cliff only two weeks ago.  
A lady working in the pharmacy called Medicare Complete twice, and then came and told us we really needed to call them ourselves.  
So we sat down on a bench at the pharmacy and did just that.  We dealt with two different ladies at Medicare Complete, and they were both courteous and helpful.  I was put on hold for about thirty minutes while one lady transferred me to another, and that was rather discouraging, mainly because I didn't know what the outcome would be.  
It turns out Cliff's former employer contacted them within the last few days to notify them that he was insured with them.  We can't figure out how that happened; I do know the oldest grandson just received his insurance card from the same employer, and we wonder if there was a mixup there:  same last name, and similar address.  If that's the case, I wonder if Arick's insurance will be cut off as a result of our mixup today. 
All's well that ends well, but we sure did spend a lot of time in Walmart, talking on the phone.  Whew.  I have to say that the ladies at the pharmacy were patient and helpful, as were the ones we spoke with on the phone.     
On a side note, I hope all the Pioneer Woman fans caught her new show on the Food Network last Saturday.  Cliff watched and enjoyed it with me; he really likes Ree.  I know she has her detractors, but Cliff and I are diehard fans.  She comes across, we think, as REAL.  We love the ranch scenes incorporated into the show, too.  Sure she's rich.  She deserves it.  I hope she gets even richer.  
So there.

Tuesday, August 03, 2010

And I was so proud to have Medicare Advantage

Evidently, at this point Medicare Advantage isn't much of an advantage any more.  Click HERE to read the article.  


"Now for the bad news: Seniors enrolled in Medicare Advantage may soon find their that benefits have been cut. Under changes contained within America's new health reform law, reduced payments to private insurers may lead to a reduction in benefits such as dental coverage and free eyeglasses. That could trigger an exodus from Medicare Advantage plans back to traditional fee-for-service Medicare, though at much higher costs."

OK, I didn't have the dental and eyeglasses coverage anyhow.  But I am definitely ready to call the guy who sold me on Medicare Advantage and see what's up.  Here's what really makes me uncomfortable.  I don't quite understand it, really; but it doesn't sound good:  "Yet in one change to the rules which has not been widely reported, people enrolled in a Medicare Advantage plan will no longer be able to switch to another Medicare Advantage program. Instead, they will have no option but to join the traditional Medicare program if they decide to leave their current plans because benefits have been reduced under the new law."  

Somebody's getting sold down the river here, and I think that somebody is me.