Teamcare Retiree Insurance Doesn't Pay If Spouse is Disabled

scratch

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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?
 

oldngray

nowhere special
They had no problem taking your money so I would think you have a very good case to sue them. Not surprising they turned down your appeal since it was them making the decision but a third party would probably see it differently.
 
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?
Damn brother
 

scratch

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Staff member
I'm trying to figure out if a lawyer will do me any good. We drove up to Local 728 last week and talked to the insurance representative. She was nice and informative, she thinks they can only go back to my actual retirement date. She did make a comment that it was my fault for not reading the Retiree Book. I don't know if she is actually paid by my Local or if she is employed by Central States/Teamcare. My online research isn't finding anything comparable to my situation. Some states only allow insurance companies to go back one year. I am looking online for "elder care" lawyers and we are going to call one Monday. My Local's representative did offer to help us write a second and final appeal to Teamcare.
 

Thebrownblob

Well-Known Member
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?
Holy crap
 
I'm trying to figure out if a lawyer will do me any good. We drove up to Local 728 last week and talked to the insurance representative. She was nice and informative, she thinks they can only go back to my actual retirement date. She did make a comment that it was my fault for not reading the Retiree Book. I don't know if she is actually paid by my Local or if she is employed by Central States/Teamcare. My online research isn't finding anything comparable to my situation. Some states only allow insurance companies to go back one year. I am looking online for "elder care" lawyers and we are going to call one Monday. My Local's representative did offer to help us write a second and final appeal to Teamcare.
My heart goes out to you my good brother
I wish I had an answer they could help you my friend
 

Commercial Inside Release

Well-Known Member
Every state has an insurance commissioner, that will investigate claims like this... Do your own research first, if it looks like they might help, then get a free consult with a lawyer (one hour free in most states.)

The state might have way more clout, than even your lawyer, and might not cost you anything. BUT... Ask a lawyer first, to be sure the state won't rule against you, and make things worse. In that case, I would still take my chances in court, just skip the investigation claim with the state.
 

scratch

Least Best Moderator
Staff member
Try that appeal again since that person offered it. Unless you already turned it down.
We are going to let the woman at my Local help with the second appeal. I'm just not sure at this time who she really works for. We are also going to contact a lawyer for legal advice. I looked on my state's Insurance Commissioner's website and they have some kind of disclaimer about national and union group insurance plans. Maybe we will contact our US Representative and Senator's offices to see if they can do anything.
 

Fido

Don’t worry he’s friendly
We are going to let the woman at my Local help with the second appeal. I'm just not sure at this time who she really works for. We are also going to contact a lawyer for legal advice. I looked on my state's Insurance Commissioner's website and they have some kind of disclaimer about national and union group insurance plans. Maybe we will contact our US Representative and Senator's offices to see if they can do anything.
It just sounds like teamcare doesn’t care
Ironic.
If $400 was being taken out of my pension fund for nothing, somebody’s door would be getting kicked in.
 

Fido

Don’t worry he’s friendly
They screwed him over big time
Gonna have to teach teamcare the 2 things in life you never :censored2: with.
1. My woman
2. My money

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scratch

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Staff member
I just re-read the latest letter and maybe it’s not as bad as what I think. Teamcare is saying they are going to try to get reimbursed from Medicare first. I still want to know exactly what my rights are.
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qdg2

Well-Known Member
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?
Hi, do you have "My Wife was told....." in writing?

You were using Medicare too? And TeamCare?
 

scratch

Least Best Moderator
Staff member
Hi, do you have "My Wife was told....." in writing?

You were using Medicare too? And TeamCare?
Of course not, this was a phone call made in 2001. My wife got a Medicare Card in the mail back then so she called Teamcare to ask what to do. If she went on Medicare, we would have had to buy a supplemental to cover doctors, medicine, vision, and dental care. So it was a no-brainer to choose Teamcare, you can't use both. Medicare is actually cheaper than Teamcare. After getting kicked out of Teamcare she got an Aetna Advantage Plus supplement for $170 a month compared to the $200 we were paying for Retiree Teamcare. I'm turning 65 in May so I have an appointment next month to sign up for Medicare and save a little money. No more doctor co-pays is another benefit.
 

Shiftless

Well-Known Member
WOW! Just now reading thru your issue. Man I sure hope this gets corrected with out cost to you!

Back when I retired the UPS HR person said basically why are all of a sudden so many people retiring?
Didn't have a clue about company growth and expansion dates.

Getting the correct info in these day's is a task, let alone when we went out!

Wishing you the best possible turn out!
 

scratch

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Staff member
I have found that asking anybody at work about retiring, pensions, contract info, injuries, etc. is about the worse thing to do. Most people have no idea and UPS HR is completely worthless. I called my former shop steward who is now a Business Agent yesterday and my story completely blew him away. I called to see who the Local's Teamcare person worked for and he thinks she is paid by the Local. I had gone by my Local to get a Withdrawl Card when I retired and I didn't think I needed to talk her.
 
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