fil moved, now outside of kaiser service area, what to do?

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squirm
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fil moved, now outside of kaiser service area, what to do?

Postby squirm » Wed Apr 19, 2017 1:28 pm

Fil recently moved, always had Kaiser, senior advantage i think. Now he's complaining that Kaiser told him he's outside their service area after he moved. What are his options? He really likes Kaiser, the closest one is about 20 miles away.

ResearchMed
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Re: fil moved, now outside of kaiser service area, what to do?

Postby ResearchMed » Wed Apr 19, 2017 1:35 pm

squirm wrote:Fil recently moved, always had Kaiser, senior advantage i think. Now he's complaining that Kaiser told him he's outside their service area after he moved. What are his options? He really likes Kaiser, the closest one is about 20 miles away.


It sounds like there are two issues: One is the distance to the nearest facility, which is thought to be "too far".
The other is whether Kaiser would allow him to use their services at all.

RM
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dm200
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Re: fil moved, now outside of kaiser service area, what to do?

Postby dm200 » Wed Apr 19, 2017 1:47 pm

squirm wrote:Fil recently moved, always had Kaiser, senior advantage i think. Now he's complaining that Kaiser told him he's outside their service area after he moved. What are his options? He really likes Kaiser, the closest one is about 20 miles away.


Which area is this? We are in Kaiser - Washington - Baltimore area. In the Medicare Kaiser plan for this area.

Yes, according to everything I read, you must reside only in certain very specific areas for each Kaiser plan. If you move out of the defined area, you cannot stay enrolled. [One possible exception I heard of is where it is an employer based program, but that does not apply to you - or me]

I don't regard 20 mile as a showstopper, but distance is not the qualification issue - the specific location is.

I would first look at the Kaiser web site for his plan and make 100% sure that his new residence is actually outside of the Kaiser area.

I know someone who will be in a similar "situation" and he plans to keep the same mailing address (that of a current family member) and return to the area for Kaiser care.

Since this is so close and it sounds like he could deal with the distance, perhaps setting up an address in the area might work.

A longshot might be that Kaiser might expand to his new residence, but an alternate address might buy him some time.

squirm
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Re: fil moved, now outside of kaiser service area, what to do?

Postby squirm » Wed Apr 19, 2017 1:49 pm

squirm wrote:Fil recently moved, always had Kaiser, senior advantage i think. Now he's complaining that Kaiser told him he's outside their service area after he moved. What are his options? He really likes Kaiser, the closest one is about 20 miles away.


Sorry, I'm implying that 20 miles isn't an issue.

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dm200
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Re: fil moved, now outside of kaiser service area, what to do?

Postby dm200 » Wed Apr 19, 2017 1:59 pm

squirm wrote:
squirm wrote:Fil recently moved, always had Kaiser, senior advantage i think. Now he's complaining that Kaiser told him he's outside their service area after he moved. What are his options? He really likes Kaiser, the closest one is about 20 miles away.

Sorry, I'm implying that 20 miles isn't an issue.


20 miles would not be an issue for me either, since much of what I do with Kaiser can be vis email, attached photos, telephone appointments and smartphone virtual appointments.

hicabob
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Re: fil moved, now outside of kaiser service area, what to do?

Postby hicabob » Wed Apr 19, 2017 2:05 pm

From my experience Kaiser coverage is very persnickety about where you live, unless you are an employee.

boglegirl
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Re: fil moved, now outside of kaiser service area, what to do?

Postby boglegirl » Wed Apr 19, 2017 8:01 pm

squirm wrote:Sorry, I'm implying that 20 miles isn't an issue.


It's an issue for Kaiser. They determine eligibility based on your zip code. For whatever reason, they choose not to offer the senior advantage plan in his new zip code, even though it seems to you and FIL that the Kaiser care is accessible.

Q-Less
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Re: fil moved, now outside of kaiser service area, what to do?

Postby Q-Less » Wed Apr 19, 2017 11:07 pm

It's a thing between Kaiser and Medicare/ government. Once the service areas are agreed on between CMS and Kaiser, Kaiser needs to adhere to it. In order to stay a member the residential address needs to be in the service area, not the mailing address.

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JMacDonald
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Re: fil moved, now outside of kaiser service area, what to do?

Postby JMacDonald » Thu Apr 20, 2017 6:32 am

I have Kaiser Senior Advantage Plan. I would not move out of the area where I live because I would lose it. If your FIL's top priority is having Kaiser, then he will need to move back into an area that Kaiser serves.
Best Wishes, | Joe

dbr
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Re: fil moved, now outside of kaiser service area, what to do?

Postby dbr » Thu Apr 20, 2017 4:42 pm

This might illustrate a reason to be careful in choosing an Advantage plan over more generic Medigap coverage. Even then Medigap may not transfer easily from state to state.

oxothuk
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Re: fil moved, now outside of kaiser service area, what to do?

Postby oxothuk » Thu Apr 20, 2017 10:22 pm

dbr wrote:This might illustrate a reason to be careful in choosing an Advantage plan over more generic Medigap coverage. Even then Medigap may not transfer easily from state to state.

Or to think carefully when choosing a new residence


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