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Medigap Insurance Fight

“You can’t fight city hall.” That was a mantra from days gone by expressing our frustration in trying to change government. Today it’s “You can’t fight the computer!”

One of the “perks” of reaching the golden age is Medicare. It was intended to be a blessing for those in retirement, and in many respects it is. But it can also frequently be a curse. I am a Type 1 diabetic and thanks to the grace of God and miracle of technology I have great tools to mange it. After deductible, Medicare part B covers all durable medical equipment for treating diabetes as well as insulin for use in my insulin pump. I am very thankful for that provision. I also have a Medicare Part B supplement (Medigap) that covers my deductible and the portion that Medicare does not cover. All is well, right? Not exactly. When I picked up my insulin from Wal-Mart, I was told I had to pay a deductible. I said, “No I don’t. I have a Medigap supplement that pays my deductible (Plan F) and the balance Medicare Part B doesn’t cover.” The friendly pharmacy tech said, “No, my computer says you have to pay the deductible, then you can submit that to your Medigap plan.” Who can argue with a computer right?

So I consulted with both Medicare and my supplement about such a refund, and they said, “You are right, you shouldn’t have to pay anything for your insulin. Wal-Mart should reimburse you for that.” That’s what I thought too, but who am I to argue with a computer? With no satisfaction from Wal-Mart or insurance, I thought next time I would try Walgreen’s. Ugh – same story. I needed my insulin, so I paid the deductible hoping this would resolve. Wrong. The story lingered for a long time. My only solution came when I called both pharmacy’s corporate headquarters. I will say that Walgreen’s was the first to get on it. Within two weeks they sent me checks refunding the money I paid. The corporate rep told me that I should tell the pharmacy tech to enter my Medigap coverage number into my Medicare account in their computer. Why did I have to do that? I had given them my card already, weren’t they trained better? Maybe I missed a retirement employment opportunity – training pharmacy techs in insurance coverage! The funny refund was from Wal-Mart. This was over a year after the fact, they finally called me and said I could go to the store for my refund. After being bounced like a pinball to three or four different people, a manger came out with a money bag and gave me my deductible back in cash! But it’s not over. About two weeks later, I got a check in the mail for the same amount from Wal-Mart corporate! I of course returned it (though I should I have kept it as interest payment).

My advice is simply find a corporate number and call them when having issues. Don’t let your hard-earned retirement money get “throne” away!

Medigap Insurance Fight

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