Humana Medicare DIS-Advantage

Humana Medicare Part D Plan


There is a lot changing in the world of health insurance, but some things are supposed to be reasonably consistent. For example, if you’re already over 65, you’re not too worried about the health care laws and individual mandates – you have Medicare and don’t have to sweat many changes.

Unfortunately, just being on Medicare doesn’t make you exempt from some of the insurance headaches that everyone is dealing with. Chief among these are processing claims and prescriptions and rising costs.

The High Costs of Being Covered

With Medicare you have a great deal of medical coverage, but not everything is covered with the plans. There are still fees and copays you have to pay, especially if you extend your coverage beyond the basic. By choosing a health insurance company for a portion of Medicare, you’re opening yourself up not only to get the coverage you need, but also for the innumerable complaints and frustrations that come with it.

Let’s say your doctor puts you on blood pressure medicine. You regularly get your medication at the local store and you have paid the same price for the drug every month for years. In December you paid $38. You go back in January and the same prescription you’ve had for years suddenly costs $75. That’s a huge increase in one month!

It’s a new calendar year, which means it’s a new year for health insurance plans. Premiums and copays have risen across the board it seems, if you’re not subsidized, but even with “discount” programs, you’re not necessarily feeling much of a discount anymore!

The Frustration of Claims

Of course, there are still the little headaches of paperwork with any insurance, but when you’re using a medical plan that is especially designed for older individuals who are bound to have additional health concerns, you can bet that you’ll be dealing with more health complaints than you might initially have expected.

Your mother might have dementia and require your assistance in handling her medical needs. You make a phone call to her insurance company on her behalf when she is first signing up for a plan. This call should protect her by getting important paperwork on file early on and setting up some notes in the insurance system.

Later, when the first shocking bill comes through for something that should have been taken care of, you’re back on the phone on your mother’s behalf. This time the message isn’t as positive. The notes in the system aren’t good enough it seems. You have to call your mother, who in her state of dementia can’t understand the conversation much less give the customer service representative information.

Then you’re told to call the doctor’s office for paperwork and call customer service back. You can’t do that without having to put your mother back on the phone, but eventually it simply has to happen. The doctor has sent over the requested paperwork, but it’s not enough to do the job, so your mother’s claim is denied. And around and around the cycle of claims and insurance drama you go.

Unfortunately it’s true that some insurance companies aren’t in business to help patients. They are in business to earn money. Often the decisions the business people make aren’t in line with what doctors recommend or even what is rational. Healthcare should be getting simpler, and perhaps it shall in the future. But for now, it is still very much a battlefield.