Teamcare Retiree Insurance Doesn't Pay If Spouse is Disabled

[Brownslave688]

We finally got an answer to our second appeal today. It took eight months, but we won. I would like to thank Rosemary at Local 728 for her help, I'm going to make her something. By law, we will be refunded every cent that we repaid to doctors since last October. This never should have happened in the first place, it has been very stressful for my wife. She was denied treatment by some of her doctors until they were paid back. We will get everything back except co-pays.



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I was just telling my wife about this debacle a few weeks ago. Glad to see this.

 

[scratch]

I was just telling my wife about this debacle a few weeks ago. Glad to see this.

We found out why we won the second appeal. It wasn't something obvious like we paid premiums for two years, all the doctor visits were pre-approved by Teamcare, or they failed to catch that my wife told them in 2001 she could get Medicare. It was only by a technicality. They couldn't find a certain form that I was supposed to have signed at the time of my retirement. They still haven't started paying back doctors since we won on May 9. We are still getting harassed over bills.

 

[LongTerm UPS Guy]

I'm finding myself currently in a big mess. I went driving in 1984 a few months after I got married. My wife was diagnosed with an eye disease in 1999 called Retinitis Pigmentosa and got declared disabled in 2001. She automatically became eligible for Medicare Plan A, which is only for hospitalization. She got the card in the mail and called Teamcare to ask for her options. My wife was told that she had to choose between one or the other, so she picked Teamcare since she wouldn't have to buy a supplemental. My wife was also told she could stay on it until age 65.

I retired in October 2020 at the age of 62, my wife was 60. My pension plan started being billed $400 a month for insurance and we thought everything was fine. Last October, my wife gets a call from her doctor saying her health insurance has been canceled. She had an appointment the next day. A couple of days later we got a letter in the mail from Teamcare stating that she wasn't allowed on Teamcare Retiree Health insurance since she could take Medicare. The letter mentioned they could try to go back to 2001 and recover all medical costs. We filed an appeal which was turned down. I got a letter in the mail today saying they want us to pay over $44,000 in past medical bills. Our position is that we paid health insurance premiums and shouldn't have to pay this back. Teamcare screwed up and didn't catch their mistake and they are trying to blame it on me for not reading the Teamcare Retiree book. Has anybody else had a similar problem and what did you do?

Several years ago Teamcare refused to pay for my insurance and disability pay citing a previous, but different injury. I appealed several times and in my final appeal I was told that it would most likely be rejected, so I mentioned that I would let my lawyer know the final outcome. Miraculously I was given all my back pay and my previous insurance bills were paid.

 

[UnionStrong]

Several years ago Teamcare refused to pay for my insurance and disability pay citing a previous, but different injury. I appealed several times and in my final appeal I was told that it would most likely be rejected, so I mentioned that I would let my lawyer know the final outcome. Miraculously I was given all my back pay and my previous insurance bills were paid.

Yup

 

[BrownFlush]

Several years ago Teamcare refused to pay for my insurance and disability pay citing a previous, but different injury. I appealed several times and in my final appeal I was told that it would most likely be rejected, so I mentioned that I would let my lawyer know the final outcome. Miraculously I was given all my back pay and my previous insurance bills were paid.

Yup

The L word always worked for me,too.

 

[UnionStrong]

The L word always worked for me,too.

They tried to deny my shoulder surgery because I dislocated it years before I worked at UPS. Uhh, that’s not how that works. You hired me as is.

 

[BrownFlush]

I've had a problem or two but nothing like the horror stories of TeamCare.

 

[scratch]

Teamcare is not your friend, I totally despise them. While I did win on my second appeal, it was only on a technicality. On their end they couldn't find a certain piece of paper I supposedly signed. The total amount of my wife's bills was $93K, which most of that went away after winning. We did lose something like $2000 because the deductibles were taken out a second time because it was paid out a different year. Which seems wrong to me, they had already been paid. We came out the best I guess, i didn't pay any lawyer fees.

I just wrote this thread to warn all of you about to retire to thoroughly investigate your pension and healthcare options. Never rely on anything you read on the internet or buddies at work. Talk to your local's insurance person or your Pension provider directly.

 

[bottomups]

Teamcare is not your friend, I totally despise them. While I did win on my second appeal, it was only on a technicality. On their end they couldn't find a certain piece of paper I supposedly signed. The total amount of my wife's bills was $93K, which most of that went away after winning. We did lose something like $2000 because the deductibles were taken out a second time because it was paid out a different year. Which seems wrong to me, they had already been paid. We came out the best I guess, i didn't pay any lawyer fees.

I just wrote this thread to warn all of you about to retire to thoroughly investigate your pension and healthcare options. Never rely on anything you read on the internet or buddies at work. Talk to your local's insurance person or your Pension provider directly.

What U Talkin Bout Willis?
With all the great legal, financial, medical, political and religious minds on this sight, why look anywhere else?

 

[scratch]

What U Talkin Bout Willis?
With all the great legal, financial, medical, political and religious minds on this sight, why look anywhere else?

It's just entertainment for the most part. I guess the Union Forum is probably the most helpful if anything. Opinions and bad advice rules here. We all worked under different pensions and insurance plans that make everything confusing.