[Fredslist] Wrongful termination of health insurance? New Medicare recipient suffers at hands of big brother health insurance.Seeks help.

[Kelly Welles]

Dear Gothamites...Need your help.
   
  A 65 year old female was referred to me with a health insurance question. A successful journalist, she signed up for Medicare when she turned 65 last summer but continued to keep her ten year old, grandfathered Aetna health insurance which provided the best quality coverage money could buy. 
   
  She was unaware she could not carry both coverages.  Apparently, most individuals who are still working (she is) make Medicare their secondary coverage and still retain the superior benefits of individual health protection to insulate them from unaffordable health costs. She was not informed about either option by either insurer.
   
  When she innocently made an inquiry to Aetna and they learned that she had Medicare, she was told they could no longer carry her and terminated her coverage with no option for reinstatement.
   
  It turns out that she had some serious health problems in the past three years,
  now under control. She is naturally concerned that she has lost the excellent protection she had. She doesn't even know about Medicare Part D so will be liable for full prescription drugs not to mention other lost reimbursement  benefits.
   
  I am now informed that Aetna was probably not within its rights to disqualify her outright; that in fact she should still be able to carry Aetna with Medicare as secondary and that Aetna should reinstate her and was wrong to disqualify her.  
   
  Does anyone know for sure?Doesn't Aetna have a responsibility to its insureds to make them aware of their rights? Shouldn't insureds be requested to sign disclosure forms affirming their acceptance of lesser terms exposing them to financial jeopardy? Can a health insurance company pull the plug at will or deceptively expose an insured to a lifetime of financial hardship by such misinformation?
   
  What is her best course of action? It seems she needs something stronger that the traditional grievance route? Is this AARP? Class Action? An individual 
  suit? None of the above?
   
  Please advise if you have expertise in this area or know of someone who does.
   
  Much appreciated, 
   
  Kelly Welles


  WELLES FINANCIAL SERVICES
Optimizing Personal Financial Assets
wellesfinancialservices.com
Kelly Welles, Managing Director
(917)626 8590
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