4 Steps for Appealing a Medicare Decision
Appealing a Medicare decision can be complex, but by understanding the steps involved and staying organized, you can navigate the appeals process.
How do I apply for Medicare?
How do I apply for a Medicare Advantage or Supplement Plan?
Can I apply for Medicare in person?
Can I get assistance applying for Medicare?
When should I apply for Medicare?
What if I missed my Initial Enrollment Period?
Are there penalties for enrolling late?
When do I get my Medicare card?
My earliest memory of medicine is an evening visit to our third-story, walk-up apartment by Dr. Deitrick, our family physician, to take my temperature, listen to my four-year old heart and lungs, and give me a shot to cure me. It worked, I guess. After that, I set the family record for most cuts, bruises, and injuries, of the six…
My earliest memory of medicine is an evening visit to our third-story, walk-up apartment by Dr. Deitrick, our family physician, to take my temperature, listen to my four-year old heart and lungs, and give me a shot to cure me. It worked, I guess. After that, I set the family record for most cuts, bruises, and injuries, of the six children, requiring medical attention. The medical world was simple then.
Beginning in the Fall, my mailbox was filled every day with Medicare Supplement plans and the TV ran non-stop ads with celebrity barkers, Joe Namath for example, touting the benefits of their sponsored plans. In December I decided to “explore” Medicare supplement plans myself. The thought terrified me, what would it cost, would it be flexible, comprehensive, could I retain my doctors, would they accept the plan? I had become quite comfortable with the WCSD medical plans and was, like others, reluctant to change. But family and friends suggested I look at other plans for significant savings. I knew immediately that finding the right plan by myself was way above my paygrade. It would be like climbing the north slope of Mt. Everest blindfolded in mid-winter. I needed help; I needed a Sherpa Guide. And I found one, her name is Susan Kist.
Susan sat at a table near the exit of Smiths in south Reno. On the table, Medicare supplement literature. I walked by her at least ten time, until one day I summoned the courage and stopped to ask her my list of questions. She listened carefully and proceeded to answer all my questions and quickly describe all the options available. And, this is important, she is not only knowledgeable, but she’s extremely affable, approachable, humorous, and efficient. She is also a bit of a teacher, giving me a crash-course on supplement plans that helped me make my own decisions. She was not selling me, up or down, on any plan, just guiding me through the pitfalls and perils of modern medical plans.
At a follow-up meeting in her office, we reviewed my requirements, and she gave me more details on the available plans. I selected and was accepted into a plan that offers the benefits I requested within a week. You helped there. I’ll be saving about $6,000 each year. For me, that’s a month of SCUBA diving at an all-inclusive resort in Cozumel, Mexico, airfare included. During that meeting, it occurred to me that there must be other retirees in the school district like me: reluctant to change, filled with uncertainty, but happy to save a buck if there is no loss of benefit. And willing to listen to an informed, friendly and reassuring third party on options. I suggested that Susan contact you to see if your office or the district has a need for her services. I’ve enclosed her business card which says in three words what I tried to in 500 words: Making Medicare Simple. I’m half Irish, gift-of-the-gab gene.
You were very helpful in this effort; I hope you’ll find this story as helpful.
I attended one of Ron’s seminars about Medicare, then scheduled a private appointment, and purchased medigap, dental, and Part D (prescr. drug) policies. Medicare is complicated, but Ron does a great job explaining the options and the advantages/disadvantages of each. It was nice to have several insurance companies to choose from, and a…
I attended one of Ron’s seminars about Medicare, then scheduled a private appointment, and purchased medigap, dental, and Part D (prescr. drug) policies. Medicare is complicated, but Ron does a great job explaining the options and the advantages/disadvantages of each. It was nice to have several insurance companies to choose from, and a knowledgeable agent to cut through the noise and share the inside scoop of which providers to consider, and why. Ron understands how confusing Medicare is for ordinary folks like myself. He was very patient as I asked a question or two which he had already answered previously. Thumbs up!
Appealing a Medicare decision can be complex, but by understanding the steps involved and staying organized, you can navigate the appeals process.
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