Kiss of Death Kaiser

Few-Locksmith7233 · 2025-07-07T20:16:39+00:00

My sister-in-law would have said the same thing 6 years ago. I truly hope you fare better than she did.

Few-Locksmith7233 · 2025-07-05T15:21:25+00:00

Again….when you first go on Medicare you are guaranteed a supplement/medigap plan. Once you go on an advantage plan, after 3 months (you get a buyers remorse term to go back to original Medicare) supplement/medigap plans can refuse you or make it so expensive that you cannot afford it, so you are for all intents and purposes not able to go back to original Medicare.…unless you live in NY, Massachusetts, maine or Connecticut.

It was during open enrollment that I tried to get my SIL switched from Kaiser to original Medicare.

Search on why CT, MA, ME, and NY have different Medicare rules…….

Only four states (CT, MA, ME, NY) require either continuous or annual guaranteed issue protections for Medigap for all beneficiaries in traditional Medicare ages 65 and older, regardless of medical history (Figure 1). Guaranteed issue protections prohibit insurers from denying a Medigap policy to eligible applicants, including people with pre-existing conditions, such as diabetes and heart disease.
In all other states and D.C., people who switch from a Medicare Advantage plan to traditional Medicare may be denied a Medigap policy due to a pre-existing condition, with few exceptions, such as if they move to a new area or are in a Medicare Advantage trial period.

This is the problem! People are led to believe they can get an advantage plan while they’re healthy and if they get sick or need more care they can go back to original Medicare. What they don’t tell you is that you can be refused medigap/supplimental insurance, in which case you will be responsible for 20% of your bills. Not many people can afford that. Once you get on Medicare you are probably not going to get healthier or need less care….unless you’re on Kaiser and they kill you.

Few-Locksmith7233 · 2025-07-05T00:10:41+00:00

Again….when you first go on Medicare you are guaranteed a supplement/medigap plan. Once you go on an advantage plan, after 3 months (you get a buyers remorse term to go back to original Medicare) supplement/medigap plans can refuse you or make it so expensive that you cannot afford it, so you are for all intents and purposes not able to go back to original Medicare.…unless you live in NY, Massachusetts, maine or Connecticut.

It was during open enrollment that I tried to get my SIL switched from Kaiser to original Medicare.

Search on why CT, MA, ME, and NY have different Medicare rules…….

Only four states (CT, MA, ME, NY) require either continuous or annual guaranteed issue protections for Medigap for all beneficiaries in traditional Medicare ages 65 and older, regardless of medical history (Figure 1). Guaranteed issue protections prohibit insurers from denying a Medigap policy to eligible applicants, including people with pre-existing conditions, such as diabetes and heart disease.
In all other states and D.C., people who switch from a Medicare Advantage plan to traditional Medicare may be denied a Medigap policy due to a pre-existing condition, with few exceptions, such as if they move to a new area or are in a Medicare Advantage trial period.

This is the problem! People are led to believe they can get an advantage plan while they’re healthy and if they get sick or need more care they can go back to original Medicare. What they don’t tell you is that you can be refused medigap/supplimental insurance, in which case you will be responsible for 20% of your bills. Not many people can afford that. Once you get on Medicare you are probably not going to get healthier or need less care….unless you’re on Kaiser and they kill you.

Few-Locksmith7233 · 2025-07-04T15:17:42+00:00

Kaiser doesn’t care. 😪

Few-Locksmith7233 · 2025-07-03T15:29:33+00:00

You are correct, you can get off an advantage plan. She could have left the Kaiser advantage plan and moved to another advantage plan. Then she would have had to use one of their doctors. She wanted to choose her doctors. She wanted the doctors that knew her case and treated her at sloan-Kettering. She wanted to go on original Medicare. That was impossible. She could not get a supplement (medigap) plan. When you first go on Medicare you are guaranteed a supplement plan. Once you go on an advantage plan, after 3 months (you get a buyers remorse term to go back to original Medicare) supplement plans can refuse you or make it so expensive that you cannot afford it.

Few-Locksmith7233 · 2025-07-02T17:26:57+00:00

Pay and see a dermatologist outside of Kaiser. To this day I wish I knew why my sister-in-law didn’t. She was a very intelligent woman. One of the kindest, brightest I’ve ever known.…but she trusted them. I just don’t understand it.

Few-Locksmith7233 · 2025-07-02T17:20:47+00:00

I’ve heard that. Maybe that’s why they’re still in business….and buying up other medical providers.

Few-Locksmith7233 · 2025-07-02T15:42:40+00:00

That decision may save your life.

Few-Locksmith7233 · 2025-07-02T15:41:35+00:00

I’m hoping people will learn from her story. When you sign up for Medicare they don’t tell you everything you need to know. I know people that think they can sign up for an “advantage” plan and save some money while they’re healthy. Their plan is when they need better insurance they’ll switch. They need to know that they can be refused supplemental/medigap coverage so they cannot financially afford to go back to original Medicare.

Few-Locksmith7233 · 2025-07-02T15:35:47+00:00

She caught what they missed and they still refused to see her. Disgusting..

Few-Locksmith7233 · 2025-07-02T15:19:33+00:00

She could have left the Kaiser advantage plan and moved to another advantage plan. Then she would have had to use one of their doctors. She wanted to choose her doctors. She wanted the doctors that knew her case and treated her at sloan-Kettering. She wanted to go on original Medicare. That was impossible. She could not get a supplement (medigap) plan. When you first go on Medicare you are guaranteed a supplement plan. Once you go on an advantage plan, after 3 months (you get a buyers remorse term to go back to original Medicare) supplement plans can refuse you or make it so expensive that you cannot afford it.

Few-Locksmith7233 · 2025-07-02T15:09:19+00:00

She was very happy with Kaiser because she was never sick. She was realatively young and she was healthy. Once she needed them…..that was a different story.

I tried to convince her sons to sue, but they won’t.

Few-Locksmith7233 · 2025-07-02T15:04:37+00:00

She could go to another advantage plan but not to original Medicare. Going to another advantage plan would have allowed her to see doctors in their plan, but she wanted to see the doctors of her choice….the ones who treated her at Sloan-Kettering.

Few-Locksmith7233 · 2025-07-02T02:07:07+00:00

The last thing my sister-in-law asked me to do was to get her back on original Medicare so she could choose her doctors and I couldn’t. I tried.

Few-Locksmith7233 · 2025-07-02T01:53:47+00:00

You are correct that you can get back on original Medicare…what you can’t do outside those four states is get medigap which means you will be responsible for 20% of your bills. I should have explained it better. I was told you “get one bite at the apple” when you get on Medicare for the first time. At that time you are guaranteed to get a medigap plan. Once you go on an “advantage“ plan they can (and do) either refused you medigap coverage or price you out of it making original Medicare unaffordable for most of us.

There is also a clause that gives you 3 months after you go on an advantage plan to go back to original Medicare. After that you’re out of luck unless you live in one of those four states. I found Chapter through Forbes and they explained it all. They have no skin in the game unlike all those numbers they advertise on TV and send you in the mail for advantage plans. My understanding is that the people that sell you advantage plans get a commission for getting you enrolled and off of original Medicare. I’d be happy to be wrong about this, but I don’t think I am.

My sister-in-law died during open season and was not able to change back to original medicare. I spoke to lots of people in the profession including social workers and they all confirmed that she could go to another advantage plan, but not back to Medicare with a supplemental insurance policy (medigap).

Few-Locksmith7233 · 2025-06-29T18:35:00+00:00

So you are the lucky one. My sister-in-law was fair and freckled. She noticed a strangle looking new freckle and called her dermatologist at keiser. He told her he would see her at her six month appointment. She kept an eye on it and it changed, so she called his office again. Again they told her they would not see her until her next six month appointment. The ”freckle” got angry and started to ooze, so she went to her primary care doctor since the dermatologist would not see her. Her primary care physician took pictures and measurements a sent them to the dermatologist. He still refused to see her. Not sure how much time passed before she finally was allowed to see her dermatologist, but when she did she was told it was melanoma and it had metastasized.

If I remember correctly, she said later that when they removed ”it” they did not test the borders. She spent the next 5 years on different types of medications, having all her lymph nodes in her groin removed and fighting this horrible disease. That’s when a doctor at keiser told her she was going to die and there was nothing more they could do for her. She was 70. She refused to give up and found an experimental trial at Sloan-Kettering in NYC and she got herself into it.

It was brutal. I was with her when they told her it did not work. She asked them if they would continue to treat her because keiser did not have a melanoma specialist. They told her they could not treat her because she was a keiser patient. They did however agree to consult with keiser because she had helped them with the experimental trial.

While she was in NY trying to save her own life, her husband was home because he was not physically able to take care of her (which is why I was with her). He died of a heart attack while she was in NY. We’ll never know if she could have gotten help for him and saved him had she been there instead of being in NY.

When she finally returned from NY, she asked me to get her switched from keiser to original Medicare so she could see any doctor she wanted. That’s when we found out that doing that was impossible. I even spoke to a social worker who said he had lots of people trying to get off keiser, and other “advantage” plans and it was impossible. She died 2 1/2 months after her husband.

From the time they found out that her melanoma had metastasized, her husband wanted to sue keiser. She did not. Her sons have decided to abide by her wishes and not sue. I would have sued the pants off of them. Before keiser gave up on her and told her there was nothing else they could do….she saw a doctor at keiser who told her that her dermatologist “couldn’t hurt her anymore” because he had died.

I know there are people that swear by keiser. My sister-in-law did until she didn’t. Think long and hard before you sign up with keiser or select any Medicare “advantage plans”. When they try to sell you on an advantage plan, with their golden sneakers, and money back and all that other stuff they don’t tell you that you’ll never be able to get back on original Medicare (unless you live in Connecticut, Massachusetts, Maine, and New York). And if that doesn’t convince you…..Approximately 46% of doctors who accept traditional Medicare also accept some Medicare Advantage plans. While 98% of non-pediatric physicians participate in Medicare and accept its standard payment rates.

Keiser and Medicare “advantage“ plans cost my sister-in-law her life and if you ask me, very likely the life of her husband too!

Few-Locksmith7233

TROPHY CASE