Problem with Devoted Medicare PPO - where to get help
 

Does any member here know of any usable Florida agency that will help a senior with a medicare advantage company issue ?

Devoted PPO plan promotes a wellness bucks benefit and then company bails on providing the benefit.

This is monies we need not have spent if we knew in advance we were gonna get stiffed.

I don't want run-arounds from wasteful Florida agencies. Many do nothing or try to sell you other crap.

This qualifies as 'senior abuse' by the medicare provider.

You can try Senors against crime and the BBB, I am sure Florida has a health care advocate, so try your local state representative to get a contact and file a complaint there also.
If (BIG IF) you have not been in the advantage plan for a year you should be able to get back to traditional Medicare without underwriting, we managed to do this when we found out that we could not get the care we needed under advantage plan.

I would contact Shine, they might be able to direct you

What is Shine ? Never heard of them ?

SHINE (Serving Health Insurance Needs of Elders) is a free program offered by the Florida Department of Elder Affairs and your local Area Agency on Aging. Specially trained volunteers can assist you with your Medicare, Medicaid, and health insurance questions by providing one-on-one counseling and information. SHINE services are free, unbiased, and confidential.

I was told by my PCP doctor to use ...
1 800 96 ELDER what a waste -- all they tried to do was sign me up for the medicaid welfare stuff that I refuse.
They referred me elsewhere that had a disconnected phone number
Dead Ends they all are so far.
Which is sort of elder abuse in itself.

I did a search (Bing) "how to file a complaint against a medicare advantage plan" and found several possible avenues to pursue, but it appears that if you file a complaint with Medicare the advantage plans has 30 days to respond. You could also try one of the local (orlando) television stations they seem to love investigating these types of problems, and of course the insurer will get a lot of negative press.

As a licensed nurse in FL, I’ll tell you what we tell our 65+ patients…go to Welcome to Medicare | Medicare. They have a questionnaire that you will plug in your meds, diagnoses, where you live, etc & come up with multiple options for you. There are companies who are reputable & get paid by the insurance companies when they get a referral, not you, but don’t push 1 insurance over another. I just have not dealt with them in this area, only in Jacksonville. Hope this helps.

maybe talk to the people at SHINE. they are Medicare people that may be able to help you. They meet at several rec centers here in the villages and Lady Lake Library. Different days and times. Eisenhower rec center 9-11:30 1st and 3rd Wed. Chula Vista rec center 3-5:30 1st and 3rd Fridays. Lake Miona rec center 9-11:30 2nd and 4th Tuesdays. Lady Lake Library 2-3:30 2nd and 4th Wednesdays. For more information 1-800-963-5337

SHINE, absolutely in their ballpark.

Sorry if you got "stiffed", but I have a few questions:

Which Advantage plan is this?
How many $$$ are we talking about?
Did you buy an insurance plan or "wellness benefits"
Was there any "fine print" about what you are and are not entitled to?

Regardless, this is a most likely a miniscule amount of $$$ and I certainly wouldn't refer to it as "elder abuse". If you really want to know what elder abuse actually looks like, I can take you to nursing homes and show you. Thank God you are not one of those that are truly abused.

From your original post, it sounds like you bought stuff then tried to get reimbursed. If so, that’s not how the benefit works. When you make qualified purchases, you use you benefit card to pay for them and pay for the balance of your purchases.

We saw a YouTube video done by Rusty Nelson on this subject with Crystal Andrus. He explained his journey in deciding Medicare vs Medicare Advantage Plan and how much help Crystal Andrus, CLTC - Insurance Broker, Sphere Coverage Solutions, Inc., Affordable Health & Life Insurance Plans in Florida & Beyond- Sphere Coverage Solutions, Office: (352) 801-7232.

I called her and she was extremely helpful in deciding which way I should go upon retirement. She looked at my meds, what services I may need and where, and I ultimately went with an Advantage Plan that was flexible enough to see my doctors in TV and NY and having them "in-network" regardless of where I am. She has answered questions both before and after signing up. I would give her a call to discuss your situation, and while she may not be able to "fix" the company you are currently with, she may be able to guide you in resolution or even changing companies.

Wait till you get older
 

Wait till you get older and as we get older and we age, it’s sad to say but we do get sicker and more medical issues. Your advantage plan might be great now, but as I said, as you get older and you have more issues you’re going to regret that you didn’t stick with original Medicare.