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Two Steps Forward, One Step Back: A multipart saga of dealing with the Medicare Part D Rx insurance industry

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Previously I explained how the Ohio Public Employees Retirement System (OPERS) made the decision to stop offering supplemental medical insurance to us retirees and, to assuage that decision, hired a firm we’ll call Firm XXX to help us all get our own supplemental Medicare insurance.  Mind you, I am not blaming OPERS for getting out of the insurance management business.  Suffice to say though, their exit process greatly complicated the lives of those of us in the OPERS Retirement system. Many of us felt like we were not dealt with fairly by Firm XXX and it took several consultations outside the OPERS system to begin to understand what we were getting into. Individually contracting with the massive health and insurance industry is intimidating and foreign to us retired people. Our understanding from OPERS was that Firm XXX was supposed to be something akin to a stock broker/investment management firm.  That is, they are entrusted with advising and managing our health insurance, and advocating for us to give us the best return to meet our health insurance needs. I can personally say that, so far, they have not done a good job for me.

I would share with you that this series of articles has created more responses than anything else that I have ever written!  It has provoked, and continues to provoke, commentary and responses, not just from local readers but a host of corporate executives from OPERS, insurance agents, and similar competing companies across the nation. As I am now writing this third part, some two to three weeks after the last publication, I got a telephone call and follow-up e-mail from the CEO of Labor First Retiree Health Exchange out of New Jersey. They bill themselves as a full access Retiree Benefits Manager representing construction workers and the like.  As they saw it, I hit the nail on the head.  He said, “Thanks again for taking my call today. Please feel free to stay in touch and keep up the great work! Our nation’s retired union members deserve the best we have to offer. At Labor First nothing is more important than member service and advocacy support!” One only wishes that our own (My) benefits manager was as responsive and progressive as they are.

After seeing my articles online, OPERS called me to initially get the facts, the backstory, and then to thank me (Whew) for making them aware that things like this have gone on, and are going on.  They said that they would be directing Firm XXX to contact me within a couple days to rectify problems, such as my not yet receiving monthly statements. OPERS, I think, was sincere.   Firm XXX, however, was certainly not an initial responder to my articles and actually has responded to me only through the intervention efforts of OPERS.  At OPERS’s request a representative at Firm XXX did call about a week later and left messages to contact them about the issue of not receiving monthly statements.  After my second formal complaint to OPERS, Firm XXX did contact me within an hour of my hanging up the phone to OPERS.

Depersonalization, degradation:

We retirees are faced with a monumental uphill task of trying to deal with a massive political and medical bureaucracy that definitely seems geared to maximizing their profits and minimizing benefits to us.  One succinctly gets the message that they hope that we will just die and stop bothering them.  As I have said, nobody has our backs.  There are no ombudsmen we can contact to help facilitate things.

Throughout this lengthy process of dealing with the retirement system, I have spent and wasted incredibly vast amounts of time with Medicare and the various health insurance organizations being forced to essentially respond to an endless loop of computers that invariably looped back to the beginning of their message. How much more impersonal can this be?  Really, is this not the epitome of depersonalization?  We are obviously not worthy of being granted a human being to converse with. “Here, babble to this machine”, they are saying. Only with great difficulty and just plain luck have I been able to occasionally talk to a real person. In prime example (Honest to God this is true and verbatim), a Mr. (garbled name) Smith, is it, left a message on my answering machine that he would like to speak to me and to please call him at this number and leave a message for him as to when and where he might reach me.  I tried in vain to reach Mr. Smith, was it (garbled name??), at that number 5 times.  You see, the number he gave me is a computer answered general contact number for company XXX where it is all but impossible to actually get a human being on the phone.  Their computer presented three options—dial 1 for reimbursement, dial 2 for old accounts, or dial 3 for opening new accounts—and when you did that you got a recorded message stating, “Call back later. All representatives are busy”. There was no “please remain on the line for an operator”. There was no please at all.  There was absolutely no way to leave a message for Mr. Smith.   In desperation and at length, by punching every number and symbol on the phone at all different hours, I did finally succeed in somehow getting a flowery receptionist who launched into a pre-prescribed diatribe about how Company XXX was happy to serve me and that they would be asking me to fill out a satisfaction survey…….. Blah, Blah, Blah, etc., etc., etc.  But she was not familiar with how I might reach a Mr. Smith. Oh, by the way, did I know that this firm has two different locations, one in Salt Lake City, Utah, and another in Fort Worth, Texas?    Since presumably she is in the same firm as Mr. Smith, regardless of location I gave her my return message to Mr. Smith indicating my cellphone number where he could always reach me.  She did not indicate whether she could or would get that message to Mr. Smith.  Some five days later I had not yet received a call from him. Might one presume that my message was not passed on to him?  Do you suppose that the garbled name facilitated this?  Absolutely!  I found out later that his name was Mr. Loynz.

So I called OPERS to explain the situation to them and make the complaint that company XXX has not responded to me.  Of course I had to relay the whole scenario once again.  I asked to be connected with the President of OPERS.  She had to put me on hold for at least 5-10 minutes to see if that was possible but ultimately got back to me. It was decided that the health insurance wing of OPERS would be contacting Company XXX immediately and I should be expecting a call shortly.  As I said before, they called me within an hour.  In the meantime, I should contact the company by e-mail and sign up for an on-line review of my situation.

Now, I don’t know about you, but on-line computer anything is a mystery to me.  Perhaps it is true that you can’t teach an old dog new tricks.  I don’t know how to manipulate this X#&XX@* computer to make this happen. Truthfully, I never will.  Call me old school.  Call me stupid. Dialing telephones and writing letters is about as far as I have gotten, technologically.  I must say though that I can get an antique automobile running, trouble shoot the system and make it work.  But I guess I’m just an old dog -not good with new tricks. For God’s sake, I can barely operate the television, let alone the DVR thing, and now you want me to do what?  Time to call my daughter again; Help.  Frustrating…….this is very frustrating!

Where are we now?  Stay tuned for part four.

 

This ongoing column is dedicated to those of us post 65’ers alone again, not by choice.  If you identify with it, please step into the lifeboat and take a seat. We’re going to make it!  I am open to ideas, feedback, and information that maybe helpful to all of us.  You can reach me at tel: 330-562-9801 or e-mail me at Skipstaxidermy@yahoo.com  

Skip Schweitzer

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