Seeking Advice and Information
Posting this for a coworker: At the end of 2019 I was diagnosed with kidney failure when I started dialysis in 02/2020. I had private insurance (UHC) through my husband’s employer and based off guidance from the dialysis clinic I enrolled in Medicare. In 07/2023 my private insurance was changed to UHC through my employer. At this time my premiums increased, my maximum out of pocket more than doubled and I learned in 2024 that Medicare was also going up another $25 a month. So, I contacted Social Security to see if I could stop Medicare and was told I could with no issues. So, my Medicare ended 2/29/24. In April and May I had multiple dr appts of which my private insurance now refuses to pay since I opted out of Medicare (Medicare would have been my primary and UHC secondary apparently since I have ESRD). They state that since I am still eligible, to have medicare 36 months post-transplant (10/2025) they do not have to pay my bills since they were secondary and only would pay what Medicare doesn't and they do not have to go by the maximum out of pocket either. I have been in contact with my benefits department, and I am being told the same thing. Obviously I made a mistake canceling Medicare but I had no idea this would happen at the time – currently I am not getting any member discounts and I am being told that I owe over $16k for those dr appointments earlier this year even though my out-of-pocket maximum for UHC is $4k. I am going to have to cancel my dr appointments for the rest of the year because of the cost. Any help or guidance as to what I can do right now is greatly appreciated, thanks!
submitted by /u/jda1226
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