I need to know how

Message Author
ampm-bookmark
delicious-small Add to del.icio.us
yahoomyweb-small Add to YahooMyWeb
simpy-small Add to Simpy
blinklist-small Add to BlinkList
PostPosted: Fri Feb 27, 2009 11:15 pm   Post subject: I need to know how  

I need to know how can I get on Medicare Ins. and drop Texas Health Spring.

I was told I might have a cyst or tumor its been three weeks. I still cannot get a referral to see a specilist. I rather have an ins. where I can go to any Doctor I want to see. The suspence of waiting is to much for me.
GenevaBalderas
New member
Leave a quick message


Joined: 27 Feb 2009
Posts: 2


1.75 Dollars($)

PostPosted: Fri Feb 27, 2009 11:21 pm   Post subject: I have Texas Health Spring  

I have Texas Health Spring Insurance. I am not Happy with this Insurance. I have to wait to long for Doctor Referrals. I rather have Straight Medicare Insurance. How do I go about it.
GenevaBalderas
New member
Leave a quick message


Joined: 27 Feb 2009
Posts: 2


1.75 Dollars($)

PostPosted: Sat Feb 28, 2009 6:17 am   Post subject:   

Well, you have opted for Medicare Advantage Plan. Haven't you read the policy document carefully while signing for the program? The advantage plan strictly states that you can't receive services from doctors apart from those in the network under normal circumstances. And, your primary care doctor would be responsible for referring you to a specialist if needed. You can't act on your free will under the Medicare Advantage Plan.

~Jeremy
JeremyHolter
Senior member
Leave a quick message

Jeremy Holter
Joined: 06 Jun 2007
Posts: 1194


210.30 Dollars($)

PostPosted: Sat Feb 28, 2009 6:25 am   Post subject:   

Hi Geneva, if you have decided to switch back to the original Medicare plan and drop Medicare Advantage, you need to inform the Medicare Advantage administrator about your decision. The Medicare benefits will begin from the first day of the following month.

Also, if you want to dis-enroll from Medicare Advantage and instead wish to join another program, you may simply have to enroll for that, Medicare Advantage benefits will automatically discontinue. However, please make an informed decision this time.

Regards,
Juanita

_________________
Insuranceguy.ampminsure.org
Juanita
Moderator
Leave a quick message

Juanita
Joined: 04 May 2007
Posts: 735

Location: Idaho
137.01 Dollars($)

PostPosted: Sat Feb 28, 2009 6:36 am   Post subject:   

Yeah, agree with Juanita…you should make an informed decision. Its important that you learn the pros and cons of every program that you wish to enroll with. I'd like to highlight few advantage of the Medicare Advantage Plan for the readers.

Medicare Advantage Plan is cheaper that the well known Medigap, which supplements the Medicare program.

With the Medicare Advantage you are not required to pay the deductibles and co-insurance attached with Medicare services. Further, you're released from dealing with the Medicare paper–works.

Medicare Advantage program covers services otherwise not covered under the traditional Medicare Program, like-coverage for eye-glasses & hearing aids, prescription drugs, dental coverage and so forth. Some of the plans also cover the traveling expenses to hospitals and pharmacies.

Therefore, weigh all the positives and negatives before taking the decision.

Hope you find the information useful.
jeorge
Senior member
Leave a quick message

jeorge
Joined: 07 Oct 2005
Posts: 808


132.58 Dollars($)

PostPosted: Mon Aug 31, 2009 1:45 pm   Post subject: Texas Healthspring  

Juanita,

I'm sure that you researched your insurance options, as did I. There are so many areas to cover and sometimes you don't know what you need until you actually need it.

I'm going through a similar problem with Texas Healthspring, right now. Some people don't understand until they're faced with a similar crisis and there's no one that cares.

My doctor referred me to a specialist reknown in pituitary tumors. Texas Healthspring has been giving me the run around with perscriptions, referrals, you name it. It doesn't matter to them about doctors referrals. What matters is the bottom line.

For the rest of you who automatically assumes that she did not research her advantage plan, don't get sick. Juanita is going through a new experience, one she didn't ask for, your compassion is about a cold as Texas Healthspring or any other big insurance company.

_________________
Register Now to have your Insurance queries solved.
Vicki
Guest






PostPosted: Sat Nov 27, 2010 2:10 pm   Post subject: Health Springs  

I have fought my battles with this insurance company many times. Along with some primary doctors. Still having problems... after paying max out of pocket ($3200) for the year. Talked to 3 different representives and was told that my wifes next treatment (co payment) would not be required. She called and was told that she would have to pay for co-payments...cancer center called and was told she would have to make co-payments...is this not part of out of pocket expense...its seems to be covered by their booklet. Its for radiation treatment... Was told to have cancer center bill them for co-payment...it seems that they are not always on the same page with knowledge...will have to cross that bridge when we get there.
_________________
Register Now to have your Insurance queries solved.
Health or Death Springs
Guest






PostPosted: Sat Nov 27, 2010 11:54 pm   Post subject:   

If you cannot get straight, solid answers from a Claims Representative, ask to speak to a Supervisor. If that person doesn't have the answer, ask to speak to their supervisor. If you get the proverbial run-around, then contact the Texas Department of Insurance. They can help.

http://www.tdi.state.tx.us/consumer/complfrm.html

_________________
California-licensed Property & Casualty Broker-Agent and Life & Health Agent. CA Insurance License #0596197. Send me your questions, and I'll send you my answers. I live, breathe, and teach insurance!
MaxHerr
Moderator
Leave a quick message

MaxHerr
Joined: 29 Nov 2009
Posts: 4218

Location: Pomona CA
162.55 Dollars($)

Quick Reply
Your Name
Subject
Message body
All times are GMT
Page 1 of 1


Get Free Insurance Quote
*State:
*Insurance type:

Ask Community Experts

flash plugin

Quick Links
Must See
Community
Insurance on Facebook
Hot topics in forums

Latest in blogs



Page loaded in 0.281 seconds.