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Re: UHC-IBM lose large health provider in Florida

 

And this shows the terrible truth about all Medicare Advantage plans. I know folks think they are getting something for nothing but there is no such thing as a free lunch in the Health Insurance industry.


Re: UHC-IBM lose large health provider in Florida

 

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Yeah, and those details will bite you in an uncomfortable place. Notice UHC's caveat. "...and accept the plan." Your research shows that SMH will not accept the UHC plan in 2024, hence you are SOL. The IBM UHC Advantage doesn't operate in a vacuum. In this case, SMH also gets to have a say, and they don't have an agreement with IBM UHC as I understand from your note.

Tim
Timothy A Johnson, Tucson, AZ ()
Member of European Train Enthusiasts ()
On 12/4/2023 7:39 AM, Michael Halliday via groups.io wrote:

HC wrote to me, warning that my health provider will go out of network in 2024. They said, in part "Your plan will cover care from Sarasota Memorial Health Care System (SMH) as an out-of-network provider, if they are a Medicare-approved provider and accept the plan. Your share of the cost will be the same as if they were part of the network."

Sound comforting? Not so. The devil is in the details. SMH told me they will NOT accept UHC in 2024 - not even out-of-network. So I must change all my doctors next year, or return to an Aetna Advantage plan (which IS accepted by SMH), and lose the IBM subsidy.

I wonder if anyone knows exactly how out-of-network with same copay even works with UHC. Without a contracted rate, how much would the provider bill UHC?? Their full rate? I find it hard to believe that UHC would swallow the difference between full rate and Medicare "usual & customary" (less my copay).


UHC-IBM lose large health provider in Florida

 

HC wrote to me, warning that my health provider will go out of network in 2024. They said, in part "Your plan will cover care from Sarasota Memorial Health Care System (SMH) as an out-of-network provider, if they are a Medicare-approved provider and accept the plan. Your share of the cost will be the same as if they were part of the network."

Sound comforting? Not so. The devil is in the details. SMH told me they will NOT accept UHC in 2024 - not even out-of-network. So I must change all my doctors next year, or return to an Aetna Advantage plan (which IS accepted by SMH), and lose the IBM subsidy.

I wonder if anyone knows exactly how out-of-network with same copay even works with UHC. Without a contracted rate, how much would the provider bill UHC?? Their full rate? I find it hard to believe that UHC would swallow the difference between full rate and Medicare "usual & customary" (less my copay).


Re: Finding my FHA on the Fidelity website

 

Log into Fidelity Netbenefits Enrollment.? Go into 2024 enrollment.? Click on FHA participation.? Click on FHA Summary.

Regards,
John Lucassen


Re: Finding my FHA on the Fidelity website

 

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Go to this website - FHA have moved to Optum:



Re: Finding my FHA on the Fidelity website

 

How do you find your FHA balance on the Fidelity website?? Previously I was able to locate my FHA account on Fidelity,?but I have either forgotten how to get there or it has moved.I just turned sixty-five so I don't know if that affects anything or not.? I'm still employed (not at IBM) so I have not started using my FHA to buy any Medicare supplement plans from UHA.
Once you turn 65, your FHA is converted to a Health Reimbursement Arrangement (HRA) and is administered by Optum Bank.

To qualify to spend the HRA, you must enroll in one of the IBM/UHC Medicare Advantage Plans. If you chose to enroll in original Medicare and a Supplemental plan, the HRA funds will not be available for you to spend unless you qualify for one of the few exceptions:

- You are a veteran and qualify for VA benefits or are enrolled in TriCare for Life
- You live outside the US
- You are enrolled in Medicaid
- You were enrolled in IBM Kaiser health plans after retiring from IBM and becoming eligible for Medicare,

Although your HRA has been moved to Optum, it may not become visible until you enroll in one of the IBM/UHC plans or prove you are eligible for an exception,

You can call Optum at 1-866-882-0397 and ask if they have your HRA.

You can find more info about the UHC plans and Optum here:
https://retiree.uhc.com/ibm


Finding my FHA on the Fidelity website

 

How do you find your FHA balance on the Fidelity website?? Previously I was able to locate my FHA account on Fidelity,?but I have either forgotten how to get there or it has moved.
I just turned sixty-five so I don't know if that affects anything or not.? I'm still employed (not at IBM) so I have not started using my FHA to buy any Medicare supplement plans from UHA.
Thanks?


IBM Virtual Stockholder Meeting - Today

 

IBM is hosting a Virtual Stockholder Meeting on Tuesday, April 25, 2023 at 10:00 AM, Eastern Time. Here is a link to it:
?


Re: Medical insurance for my husband after Cobra is expired

 

On Thu, Apr 20, 2023 at 10:55 AM, Mary wrote:


none of the advantage plans are accepted in this area
The new IBM United Health Care Medicare Advantage Plan, that I signed up for this year, does not restrict me to "in-network" providers. If the doctor (or hospital) accepts Medicare, I can use them. I suspect this would apply to you too.

I also had a prior Medicare Supplement and resisted being "forced" into an Advantage plan. But after a bit of research, it was far better for me, than any Supplement or other Advantage plan that I could find.

IMO, fighting the "loss" of your $40,000 is a losing proposition. Suggestion: dig a bit deeper into the terms of the new Advantage plan and how it would apply to you.
.


Medical insurance for my husband after Cobra is expired

 

I retired last year and started Medicare - I didn't know anything about an IBM Medicare plan, so I got the AARP United Health Care Supplemental insurance.? ?I was told when I retired, that I could get COBRA for my husband(he is 5 years younger than me), for 1.8 years, then use the VIA benefits to get his insurance until he was Medicare eligible.? I just called and found out that unless I "switch" to the IBM united Health care advantage plan(none of the advantage plans are accepted in this area) I can't access those funds for any reason????

Really???? does anyone know if there's anything I could do?? Looks like they just swiped a bout 40000 away from me.

Mary


Re: Signed up for IBM Advantage, How to claim against FHA balance in 2023

 

Final followup for my case.? Got 2 ETF transactions to the bank account.? One for the Jan+Feb medicare part B premiums for my spouse, the other for all the March reoccurring premium dollars I had filed for. Interesting in that in the details it showed my UHC premium plus double MY Medicare B,? and NOT as a Medicare B for me and another one for my spouse which I would have expected.? The end result $ was correct so I'm moving on.


Re: Signed up for IBM Advantage, How to claim against FHA balance in 2023

 

That’s insane! Have you called the IBM ESC to file a complaint with the Plan administrator? This change is worse than the transition to Via Benefits.
The other thing I’m finding is that I’m getting billed addl $20 copays for things done at my Dr ofc visits. Dumb me never thought to ask. One specialist visit actually cost me the $30 visit copay + (2) $20 copays for tests he did. I had surgery planned for Dec 2022 which would have cost me $0 OOP last yr but I got the flu so had to resched to this yr. Under this UHC plan it cost me $100 surgical copay + $250 hospital copay + god knows what else when all the billing gets settled. I’ll prob reach the $750 OOP max in 1Q. This yr the $1,200 transition credit will cover that but I’m already wondering what changes to this plan will happen next yr after we pass the 1 yr ability to revert to our medigap plan. My spouse & I will likely both opt to revert as there’s too many unknowns down the road w/this one. Maybe that was IBM’s plan all along as a way to get rid of paying our subsidies??


Re: Signed up for IBM Advantage, How to claim against FHA balance in 2023

 

Continuing the saga.... Called Optum again again today.? Talked to another Optum agent explaining the situation all over again giving the escalation ticket # from the previous call and that while MY medicare part B was paid, the claim for my SPOUSES medicare part B has not, nor does it appear as pending nor denied.? Agent said I won't see it on my account dashboard ????.? Why not I wonder???? It's a claim against the same FHA funds for the spouse.? Then I got transferred to United Health Care Benefits who wondered why I got there as it is not a UHC Benefit question but a FHA HRA issue... so got transferred again.? After talking with next agent for a little bit it came out that this agent was with Via Benefits !!!!? Why UHC Transferred the call to Via Benefits rather than back to Optum is a mystery (or is it misery ;-) .. so Via Benefits tried transferring the call back to Optum but after several clicks things were disconnected.? Only a 1/2 hour of wasted life to get nowhere.? Called Optum again and got a different agent.? Explained it all again, agent found previous agent notes and after a few more minutes said they were going to resubmit the claim again and it should be processed in about 3 days. ... same story a previous agent told me.? This agent did think one of the agents sent the bank account direct deposit information to the wrong department.? I guess while the account was verified, internally something didn't get properly linked during account setup but the agent that saw the "bug' initially sent the corrective action to the wrong place.? Then while I said I'd answer a survey at the end of the call, I got a dial tone.? I guess they really didn't want my 2 cents worth at this point!

I did get an explanation as to why there are 3 HRA accounts for me.? One active one for this year, one for last year as an artifact, and a dormant one that will hold FHA funds if I drop the UHC health plan in the future.? Can't claim against that one, it would just be a reminder of the promised IBM Funds that one could not access.? Those funds would continue to get interest credits.? Rather than spend all the FHA funds to zero, maybe that is the one to leave a little bit in if one would ever want to come back to IBM's then current health plan if one dropped the current plan and went back to traditional Medicare.


Re: IBM UHC Plan C Funding Issues

 

Retirees really?are just a number in the liabilities column to IBM. Sad ...
?
Bob Young


On Mon, Feb 27, 2023 at 9:31?AM Silverskates23 via <burgerspear=[email protected]> wrote:

For those of you that haven’t seen this & are interested in the signing the petition. My spouse & I both had issues getting our Optum debit cards & had to shell out our own $ in Jan. Folks w/FHA accts seem to be worse off since their premiums are billed in advance ?



IBM UHC Plan C Funding Issues

 

For those of you that haven’t seen this & are interested in the signing the petition. My spouse & I both had issues getting our Optum debit cards & had to shell out our own $ in Jan. Folks w/FHA accts seem to be worse off since their premiums are billed in advance ?



Re: Signed up for IBM Advantage, How to claim against FHA balance in 2023

 

It's been another week+ and Optum still hasn't paid spouse's Medicare part B reoccurring claim filed Feb 4th.? Another call to an agent and he agrees he sees the correct documents supporting the claim and the account has funds.? He put in an escalation ticket to the claims department to try to figure out why nothing is happening.? My Medicare part B claim submitted at the same time was paid by snail mail check even though the direct deposit account was set up and verified.? On that part, the agent said Optum had a "bug" but would be corrected for March's payment.? But he had no explanation as to why Jan & Feb for my wife wasn't processed.


Re: Signed up for IBM Advantage, How to claim against FHA balance in 2023

 
Edited

I submitted wife's Medicare recurring premium the first week of February and it was processed for both Jan. & Feb.within a few days (weekend was involved). I don't submit any claim for mine as I am eligible for SHAP. At the end of the year, when I have received the $900, I file for the difference if there was any funds left in my HRA for the year. If you retired after 1996, you aren't eligible for SHAP. On the back page of the SHAP form, it discusses eligibility. You can download a copy of the form here: ?

It is the 3/22 form the latest version. A duckduckgo (or google) search will turn up an older version, but still has the same requirements on the back page regarding retirement year. BTW, keep in mind, VIA is the go-between us and Acclaris, If you had a NetBenefits account before, it no longer worked for me.

Edited to remove period added to link address. Apparently, there is a bug in it ignores spaces after a URL and adds whatever follows to the URL resulting in a bad link.


Re: Signed up for IBM Advantage, How to claim against FHA balance in 2023

 

All is not as well as I had hoped.? I submitted Part B premiums for myself and wife on the same day.? They say they are paying mine for Jan & Feb (finally, but nothing has appeared at the bank yet) but it appears they think my wife's premium expense is a duplicate as it is for the same annual reoccurring period, same amount but DIFFERENT person.? Expense journal shows $0.00 unpaid expenses, payment for my premiums "paid" days ago but no deposit in bank, nothing pending for my wife.? Go figure.


Re: Really Confused about these IBM changes

 

That $2778? includes the one-time $1200. As soon as that is used, that $3000 becomes $1578, until the government raises the monthly SS Medicare deduction again. IBM has screwed the retirees with this in many ways. For those of us who were getting the $3000/3500 and selecting one of the VIA plans took a hit. I had an Aetna PPO plan that is nearly identical to the UHC plan - the difference being IBM has a "Group" plan that "supposedly" allows one to go to any doctor in the country that accepts Medicare where the Aetna plan provides for any doctor within my locality that accepts Medicare. Aetna does (and corresponding plans do) allow for emergency treatment if traveling. For most people, that is probably sufficient. That Aetna plan had $0 monthly premium plus the $30 reduction in the monthly government SS/Medicare "premium". So aside from the one-time $1200, that annual $1300 (or, in your case, $1578) is a considerable drop from the $3000/$3500. While going through the annual "Medicare and You" book, other companies had similar $0 monthly premium plans. Please note -? I am only addressing the Medicare Advantage plans as that is what the UHC plans are and what I have had from Medicare for years.


Re: Signed up for IBM Advantage, How to claim against FHA balance in 2023

 

Glory hallelujah, the FHA money finally arrived yesterday into yet a third account, and batch processed overnight showing up today. The other two still have a zero balance, one I can understand as it was for 2022.