Pamela – Michigan

Pamela’s Story

When I had to retire from teaching I was given 2 choices for insurance Blue Cross and Priority Health. When I won my disability case I was told that I would automatically be enrolled in a Medicare Advantage program with the same 2 choices. I stayed with Priority Health because it costs less. For the past 2 years I have gotten a lot of phone calls pestering me to do the in home health visit. I always refuse but they keep calling! It stops for a couple months then begins again. I have never yet been denied coverage but I’ve had to jump through many hoops. Before I could get knee replacement surgery (which my doctor recommended after my scope surgery before he retired) I had to see the doctor he recommended. Then I had to get a series of 3 injections. Then I had to wait to get back into the doctor. Next I was sent for another MRI, go back to the doctor and insist on getting surgery. So it’s been over a year and a lot of money spent and my surgery is finally tomorrow. Then there’s the coverage gap which I’m in again. Last year I paid $6500.00 out of pocket, this year it’s $7050.00. I know a lot of people are worse off than I but I am literally living month to month!

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