Due to change in living situations, I was forced to cancel my Kaiser Permanente coverage aften 46+ years. I am a Federal Retiree and during the Open Season with the help of my Congresswoman's office I chose a Nationwide company and did everything necessary including closing visits with my doctors. I used the new coverage in January while I was in New York without a problem. When I came home to Southern CA late in January I found mail from Kaiser telling me that I had been approved by Medicare to have their coverage as of 2/1/2013. I checked with OPM in DC and they said to ignore it that my proper coverage was in place. I destroyed the new Kaiser Cards (3 in separate mailings) and went on with my plans to establish myself with the Doctor of my choice.
Now, I have seen the new doctor and she prepared new prescriptions (as mine were running out) and ordered lab work. I am almost 70 years old and have several serious chronic conditions which require ongoing consistent medications.
When I heard from a provider that I could not get services because Medicare is not my primary coverage I inquired further and found that Kaiser had enrolled me without any request or permission and that I could not get anything without going through them.
Here's the catch, when I had called Kaiser to have them remove their name from my record I was told that I had to request it in writing with a signature and that since it is not open season they might not recognize or honor my cancellation. I told them that I had not authorized the coverage and I was not going to sign anything that could imply that I had.
After several long calls to Medicare and Kaiser (threatening them with an official Complaint) they acknowledged that they had enrolled me in their Individual Senior Advantage Program as of 1/18/2013 because they had checked and saw that I was eligible for Medicare (so what!). After putting me on hold for a long time for them to speak to a supervisor the lady came back and told me that they were attempting to assure that I would not have a break in coverage (bull ...).
I did as Medicare Operator instructor and called them back with the information and an Escallated Complaint has been sent "up the chain". Problem is that I am getting more ill and cannot get assistance unless I go to Kaiser and if I do, that will acknowledge that I accept what they have done and I will legally becomme financially obligated to them for the rest of the year. I live on two coasts and they are not available in NY and have limited Out of Area allowances.
So, here I sit having my drug coverage (for which I have paid) not being honored and scared to death that I cannot get this straightened out before I become critically ill. Do they think because I am old, I am stupid? God only knows how many retired federal (and others) employees find themselves in this same mess. After supposedly taking care of me for over 46 years they are ready to cause me illness and possible death if I do not come back to them.
Everyone, please check your situation and if this has happened to you please please report it! It is Missrepresentation and Elder Abuse. It is one of the things that causes Medicare to go broke and all of us to pay more for all these services.
If anyone can guide me through this-please do. The time, money, stress and distress this is costing me is unfair and I don't want to see anyone as sick and upset as this has made me. Let's be smart and stick together. Personally, I think other HMO's do the same thing but this one I can prove and want to report. They promised me that they would have their name off my records by Thursday and when it was not, the Complaint was filed.
On Friday when it still was not off and my medications were being denied by the coverage I paid for I go sick. My stomach, my colon, my heart and my blood pressure along with my sugar levels are all in need of help and I am trying not to go to an emergency room. I have 3rd Stage Kidney Failure and I can't seem to stay hydrated.
Help me-help us. Let's keep them honest and us as well as we can be for as long as we can.