We are a charity and rely on donations

Charity Number: 1117194 (England and Wales)

Registered Company: 06000961

Registered address:
Shift.ms, Platform, New Station Street, LS1 4JB, United Kingdom

London office:
Shift.ms, Somerset House, Strand, West Goods Entrance, London WC2R 1LA, United Kingdom

©2024 Shift.ms

@mrswithms 

Last reply

mrswithms

Anyone else on Medicare Part A having UHC deny claims?

Anyone else experiencing a major shift in their 2024 private health insurance coverage based on Medicare Part A enrollment? I just spoke with my health insurer, United Healthcare, and was informed they would only pay for my Briumvi infusion based on the amount that is covered through Medicare Part B. The remainder, $37, 519, would be my patient responsibility. I was shocked! I am disabled which automatically enrolls me in Medicare Part A (which covers hospital based services). I chose to keep private medical insurance through my spouse and declined Medicare Part B 4 years ago. Evidently, UHC has enacted a new clause that states for anyone offered Medicare Part B, UHC will only pay the amount that Medicare Part B would have paid which is $260 out of a $37,766 bill. Mind you, I do not have Medicare Part B and I'm continuing to pay monthly UHC premiums. Anyone else encountered anything similar? After living with MS and dealing with health insurance for the past 10 years, I've never been so mad.😤
Canton, United States
2
@BuckGrundle
@BuckGrundle
 

I had a lot of similar problems when I was first diagnosed. I would explore Medicaid. A lot of states have what is called a spend down clause in the event that your household income is too high to qualify. Being disabled, you might be able to get enrolled in that kind of program, which would eliminate your share of any medical costs. For the short term. I suggest calling the pharmaceutical company that makes your medication. When I had this problem. I contacted the maker of the medicine, and they enrolled me in a co-pay assistance program that took my monthly cost from $5000 down to zero. Feel free to direct message me if any of this needs more clarification. I don’t want to suck up too much space on a reply. Good luck!

@mrswithms
@mrswithms
 

@BuckGrundle , thanks for your reply! I did circle back with my drug maker and they got on the phone with UHC to straighten out the mess. I suppose it's to be expected health insurance companies are trying to skirt around these high-priced pharmaceuticals. But I caught them doing it without just cause. I'm still upset at the distress they put me into thinking I was solely responsible for $50,000+ in medical bills.