How to get rid of current insurance from Medicare ?

[ChihuahuaMom]

What is the name of your state (only U.S. law)? PA
My husband is 64 will be 65 in a week. We received a letter stating that the insurance my husband has (Cigna Health Spring ) will no longer be associated with the Hospital ( Crozer Chester Medical Center ) he can not use or our primary care physician that we have been seeing for over 25 years or so. They wanted him to go to a doctor that we will not go see ( he was a contributing factor in my nephew's death which the family received money from it ) knowing that this was happening he enrolled in another insurance (Colonial Penn) . He sent Cigna a letter that he wanted to cancel because he had another carrier. Thinking this was taken care of he felt that he was covered.

My husband has been diagnosed hypertrophic cardiomopathy . We have been going to doctors in Philadelphia so that was no problem for his heart . A couple weeks ago he was taken to the emergency room of another hospital that he could go to and diagnosed with colon cancer . . He held off seeing doctors because of the insurance fiasco. Waiting until the first of July which he thought he would be covered and would be able to go to the hospital and doctor he wanted to go to . Before he could start Chemo the heart doctor said he should have a defibrillator put in for his heart .
Thinking he was covered by Colonial Penn supposedly effective July 1 ( could use Crozer and our primary care physician ) so he went to Crozer for the procedure . He even called Medicare to make sure he would be covered of which they said Medicare was primary and the Colonial Penn would be secondary. But Cigna still showed up on the computer. He still needs to have a port put in for Chemo.

So now he has to wait to get this straightened out before he can start his treatment.

He has tried calling, Medicare, who told him to call Social Security, who gave him another number to call...and so on and so on and so on....he was told that he could not drop Cigna.

Can anyone give us an idea or phone number to call to try go get this big mess straightened out ?

Thanks for your help.
Sandy

 

[cbg]

I work with employer-sponsored group insurance, not individual insurance.

With group insurance, it would not be enough for you to send them a letter saying to drop CIGNA. You would have to send written verification from a third-party source (Colonial Penn directly or your employer) confirming the date on which the new coverage started, and you would have to send that to them within 30 days of the date the new coverage began. Once that 30 day window expired, BY LAW you would not be able to cancel the CIGNA coverage until the next open enrollment period.

While I don't believe individual coverage is subject to the same laws, most of them have similar procedures, and they CAN legally stick to them. How long ago did the Colonial Penn coverage begin, and did you ever send them any proof of coverage except your letter?

FYI, it's not up to you whether Medicare or your supplemental plan is primary. That is determined by the plans themselves.

 

[ChihuahuaMom]

I work with employer-sponsored group insurance, not individual insurance.

With group insurance, it would not be enough for you to send them a letter saying to drop CIGNA. You would have to send written verification from a third-party source (Colonial Penn directly or your employer) confirming the date on which the new coverage started, and you would have to send that to them within 30 days of the date the new coverage began. Once that 30 day window expired, BY LAW you would not be able to cancel the CIGNA coverage until the next open enrollment period.

While I don't believe individual coverage is subject to the same laws, most of them have similar procedures, and they CAN legally stick to them. How long ago did the Colonial Penn coverage begin, and did you ever send them any proof of coverage except your letter?

FYI, it's not up to you whether Medicare or your supplemental plan is primary. That is determined by the plans themselves.

My husband has been out of work for the last 10 years. He went out on Medical (heart) problems. Thanks for your input.

Sandy

 

[cbg]

That's why I made the distinction between group and individual plans. A group plan MUST require proof of new coverage. An individual plan MAY require proof of new coverage. A group plan MUST limit the window to 30 days. An individual plan MAY limit the window to 30 days. It is more common that not for an individual plan to follow the same rules as a group plan.

Was such proof provided? If so, was it provided within 30 days?

 

[ChihuahuaMom]

That's why I made the distinction between group and individual plans. A group plan MUST require proof of new coverage. An individual plan MAY require proof of new coverage. A group plan MUST limit the window to 30 days. An individual plan MAY limit the window to 30 days. It is more common that not for an individual plan to follow the same rules as a group plan.

Was such proof provided? If so, was it provided within 30 days?

I'm sorry. I believe the proof was provided. Hopefully this will be resolved in the next week or so. I called our local state rep and they have someone that comes to their office to help with things like this. We have an appointment on the 23.

Thanks for your info and time.
Sandy