30 months post Transplant

[kaci]

DH has made it through his 30 month coordination period of having Medicare as his secondary and his employer's insurance as primary. Now MC goes primary for the next 6 months until it expires and his employer's insurance is trying to jack his rate up almost $1000 a month now that MC is primary payer. Has this happened to anybody? How was it resolved? DH has spent most of the afternoon on the phone with the SS office and Kaiser and they're both giving him the run around...

[lmunchkin]

My husband was working during his kidney failure where he had group ins that paid everything. Like you, we were told MC would be prime after 30 months and group would be 2nd.  But they never increased his premiums due to his illness, they did go up on their rates on all employees due to rising cost in medical costs!
Does he have an Humon Resources or Benefits Dept where he works?  He could check with them, cause that is why group ins is so good , cause the premiums are shared amoung the group!   The larger the group, the lesser the premiums.  At least that is my understanding of it!
It seems unfair to single an employee out & make them pay more, but hey, nothing surprises me anymore!

Check more into it! There ought to be someone who can shed some light on this! Hope you get it straight, cause unfortunately, financing this disease is enormous!

Wishing you luck & let us know what you found out,

lmunchkin     

[okarol]

Each state has it's own insurance commissioner. If it were me I would call and find out what rights he's got. http://www.insurance.wa.gov/ - it seems really unfair! Plus, medicare will be paying more for 6 months, so why the increase now? And what will protect him after Medicare expires? If you don't get a satisfactory answer I would file a complaint with the commission.

[kaci]

Thanks so much for the replies! Unfortunately his HR director is the one who is telling him HE has to get this straightened out our she's just going to take the additional premiums out of his check GRRRRR... I gave him the email for a volunteer organization that works with the State Insurance commission and can hopefully get this straightened out.

After medicare expires he will still have his employer's group health plan (Kaiser) that has been really excellent insurance for the 8 years we have had it, until now I'm hoping they aren't thinking they're going to make this rate hike permanent, I just don't understand how/why they're singling out my husband.

[okarol]

Did you go to that link for WA? It gives another link http://wainsurance.blogspot.com/2011/07/health-insurance-rate-requests-now.html
Health insurance rate requests now public
Individual and small employer health insurance rate requests are now public. See the complete filings received since July 1, as well as a summary for each request.
I looked at Kaiser's, who had requested at 13% increase, but that request has been withdrawn.
http://www.insurance.wa.gov/consumers/health/transparency/documents/231368-Decision.pdf
Keep following up, don't give up!

[kaci]

Thought I would update... After dealing with Social Security, Medicare, Kaiser, WA Insurance Commisioner and I can't even remember who all for months it was finally decided today that this was all a billing error on Kaiser's part.

We are very happy not to be on the hook for that $5,000! 

[tyefly]

I have kaiser insurance too....  I am self employed and pay insurance thru our business.... small business.... we offer inurance to our employee's as well..... My rates have gone up every year.... three years ago  they went up 24%  then the next year 17% , the next year 21% and now this year 18%....  I have  another 6 months before my 30 months are up.....  I sure hope my rates dont go sky high ( er )  when My 30 months are up.... we live in Washington state too.....  it getting so expensive to pay for health care.....  I pay 111 for medicare and now 558 per month per person for kaiser insurance.... yes its a good plan  but  for both the husbund and I  along with medicare it alot of money.... 1227.00 per month and I pay roughly 275 for percriptions.... which is 1454.00 per month for our family.... that 17,448.00  per year..... and I didnt include the copays for each doctor visit.......

   Going for broke..........LOL