by moms ins » Tue Mar 25, 2008 01:19 pm
My mom infomed me yesterday that as of 4/30/08 she will no longer have health ins from secure horizon which use to be united health care last year thru solutia. Something about a law suit that soluita had. My mom is 77 and has all kind of health problems. Is this even legal to just drop her like this? What are her options, its only a month away.
Worried
Worried
Posted: Sun Nov 21, 2010 02:47 am Post Subject:
Elderplan is unique to New York State (which is its own animal when it comes to all forms of insurance). When they speak of "dual eligible" persons, they mean a person who qualifies for both Medicare and Medicaid. It predates most of today's Medicare Advantage plans by more than 20 years.
You have to let go of the whole "primary and secondary" business that is interfering with your understanding of these things. Primary/secondary is only a discussion of Group/Individual insurance vs. Medicare. When a person is a beneficiary of both programs, they soon discover that Medicare does not pay for everything. It won't pay for eyeglasses, hearing aids, or guide dogs for the blind (it won't even pay for a red-tipped white cane to get around town), or long term care beyond 100 days. But Medicaid (which is funded with Social Security and Medicare dollars) will pay for those things. It is not a discussion of primary/secondary, it is a discussion of covered or not covered under Medicare.
What is the difference between a Medicare Advantage policy and a supplement plan?
The difference is like day and night.
Medicare Supplement insurance policies fill in some of the "gaps" created by the exclusions and out-of-pocket costs in Medicare Part A and Part B ("Original Medicare") when it comes to paying hospital and doctor bills. Medicare Advantage plans substitute an HMO or PPO plan for Original Medicare.
I'm trying to recall what state you are in. As a licensed insurance person, I find it odd that you don't know this stuff already.
As for Secure Horizons' Evercare program:
What We Offer
Evercare is a leading provider of health plans for people who have long-term or advanced illness, are older or have disabilities.
Posted: Thu Aug 25, 2011 08:53 pm Post Subject: Evercare & supplemental insurance
Does Evercare in Wisconsin take the place of a supplemental insurance policy?
Posted: Fri Aug 26, 2011 09:52 am Post Subject:
Evercare is a Medicare Advantage plan from UnitedHeealthcare. If enrolled in Evercare, one does not need a Medicare Supplement insurance plan. You cannot have both, because the Medicare Supplement plan will pay nothing.
Posted: Sat Aug 27, 2011 11:29 am Post Subject:
Medicare covers short-term recovery from an illness or injury. If you need time in a nursing facility to recover from a stroke,or a broken bone. If you're planning for yourself, or caring for an older relative so that's is right .
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Insurance Adjusters
Posted: Sat Aug 27, 2011 10:03 pm Post Subject:
Medicare covers short-term recovery from an illness or injury. If you need time in a nursing facility to recover from a stroke,or a broken bone. If you're planning for yourself, or caring for an older relative so that's is right
None of this makes any sense. Medicare is not for "recovery".
Medicare is health insurance -- Part A for hospitalizations, Part B for physician, surgeons, and outpatient hospital expenses. It only pays (under Part A) for "SKILLED NURSING FACILITY" confinement if (1) it follows a minimum 3-day period of hospitalization AND (2) is "medically-necessary".
If a person is caring for someone in their home, Medicare has no benefit for that other than HOSPICE care for a terminally-ill person. Recovery from a "broken bone" generally does not require skilled nursing facility care; a stroke might. But a person who suffers a stroke may need years of care, little of it skilled nursing, for which Medicare pays $0. At most, Medicare has a benefit for only 100 days total, of which only 20 are covered 100%.
Long term care insurance is not comparable to Medicare -- it does not pay for the things Medicare pays for, and Medicare does not really pay much for the long term care expenses of a person.
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Posted: Wed Nov 16, 2011 08:06 am Post Subject:
Try a pharmacy.
Posted: Wed Jul 09, 2014 07:28 pm Post Subject:
I was told that medicaid wassuppose to be for a year. (NM) I have recently seen plans being dropped in 6 months. Is this somehing new on the medicaid eligibility?
Posted: Thu Jul 10, 2014 02:09 pm Post Subject:
No one gets "medicaid . . . for a year." Medicaid is technically a month-to-month program based on meeting the eligibility requirements. Eligibility may terminate at any time a person fails the test of income. Persons age 55 and older who require assistance with long-term care expenses must also meet a separate test of assets in addition to income.
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