Complaint 2 of 5 in “Medicare / Medicaid Issues”
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- Insurance Carrier: Pyramid Life Ins. Co.
- State: GA
In December, I phoned and wrote to Todays Options Insurance to cancel my mother’s medicare advantage policy. I had taken out a Medicare Supplement Policy with AARP. In February & March Today’s Options continued to pay claims and refused to come off the risk following repeated telephone calls. In March I sent a certified letter. Their response was that they were off the risk effective March 31. Current EOB’s show \”member not eligible for benefits\” for claims filed services which were performed after 3/31/08. Despite repeated requests and several formal complaints filed through Medicare, Todays Options has yet to inform Medicare that they are off the risk. Current health care providers, pursuant to the Medicare Common Number procedure are advised to file with Todays Options and their claims are refused. Providers cannot file correctly with Medicare and AARP because Medicare’s current system only permits filing with the carrier listed under Medicare. If this impasse continues health care providers will shortly refuse to treat her because they cannot collect their bills.
Insurance Expert Answer:
Call AARP and ask its help. Dealing with the interface between an insurance company and its bureaucracy and Medicare with its bureaucracy is not for mere mortals, but I can suggest a letter to your US Senator or House of Representatives member may be needed.