Action: Bill not covered by Medicare

On July 18, 2000, I developed terrible chest pains, and at 4 a.m. I called 911. The EMTs found it necessary to transport me to the hospital at 4:40. Being alone with no other help available, I agreed to be taken to the emergency room at a nearby hospital. I do have a heart condition and other medical problems, and I am on different medications. Nonetheless, Medicare refused to pay the bill of $390.40. The bill was turned over to a collection agency.

I am 77 years old and on Social Security, which is $953 a month. My savings account is less than $200. My prescriptions run to over $250 a month at times. With rent and other expenses, there is nothing left by the end of the month. I do realize that the ambulance company needs for be paid for the outstanding service it provides. But it seems unfair when senior citizens in a low income bracket have to pay, since Medicare should cover the bill. T. Nupp

Response: Medicare does not pay for ambulance service unless the person's life is in immediate danger. Had your doctor been able to document this, you could have appealed Medicare's decision. Appeals must be filed within six months from the date a claim is processed by Medicare, however, so it is too late to do so now.

If you need transportation to the hospital in the future, call the state's Department of Elder Affairs senior helpline for referrals to private sector transportation services. You will have to pay for this service, but the bill will be significantly less than that for a ride in an ambulance. The number is in the state government offices section at the beginning of the phone book. Alternatively, call the statewide senior helpline toll-free at 1-800-963-5337 to automatically be transferred to the office nearest to you.

The helpline can also offer access to SHINE (Serving Health Insurance Needs of the Elderly). This service is staffed by volunteers who are trained by the Department of Elder Affairs to help people over the age of 60 with health insurance questions and problems. If you indicate you are having a Medicare billing problem, for instance, a SHINE volunteer will contact you.

Finally, the helpline also has a number of publications about insurance, supplemental insurance comparisons, Medicare and so on. This can be particularly helpful for people who are approaching Medicare age and will need to make decisions regarding supplemental insurance and so on.

Canceled cruise

I am writing to you on behalf of a friend and with his knowledge. Abbott Webber has been a patient in the hospital since Nov. 21. He and his wife had planned to go on an extensive world cruise in January. They sent in their initial payments and purchased cancellation insurance from the company that was recommended by their travel agent. They paid the travel company a total of $36,000 (down payment), and they paid the insurance company Travelex a premium of $7,000.

In August Mr. Webber suffered a ruptured aorta aneurism, but he survived the surgery and, at the time, they still had hopes of going on the trip. Then, on Nov. 20, he learned that he was to undergo triple bypass heart surgery. Mr. and Mrs. Webber knew at this point that they would not be able to take the trip in January, so they called and canceled it on Nov. 20. The insurance company sent them forms to fill out. This was done, and those forms were faxed to the insurance company on Dec. 15.

Since that time, the insurance company has made one excuse after another for not being able to process the claim. The last communication from it, received on Jan. 17, stated that the attending physician's statement was required, even though that statement was filled out and sent to the company on Dec. 15. Travelex said the doctor needed to fill it out again and this time fill in every blank. We personally carried the forms to the doctor. I believe the insurance company is trying, in every way it can, to avoid payment of this claim, even when it assures us that once the additional information is received, it will proceed with the evaluation. Wilkes Macaulay

Response: In your words, "I would like to express my thanks to you once again for the results you received in helping my friends resolve their dispute with the Travelex Insurance Co. . . . While the Webbers still have not received the check, they have been assured by the company that their claim is approved and the check is "on the way.'

"We had been working with them for two months, and I am confident that the company would not have brought this to a conclusion had it not been for your intervention through Action Line."

Battery rebates

I have used hearing aid batteries for many years and had taken advantage of Energizer's rebate offer for the past four or five years. On Dec. 18, I sent 12 package tops to Energizer and asked for a rebate of $12. A check came from Energizer on Dec. 28 for $3.

I plan to send a letter to Energizer protesting the amount sent to me. I have documentation to support my protest; however, I'm not sure as to where or to whom I should send it. Can you help? Forest Wiley

Response: Energizer has three more checks coming your way. The number to call in the future is toll-free 1-800-733-7151.

- Action solves problems and gets answers for you. If you have a question, or your own attempts to resolve a consumer complaint have failed, write Times Action, P.O. Box 1121, St. Petersburg, FL 33731, or call your Action number, (727) 893-8171, or, outside of Pinellas, toll-free 1-800-333-7505, ext. 8171, to leave a recorded request.

Requests will be accepted only by mail or voice mail; calls cannot be returned. We will not be responsible for personal documents, so please send only photocopies. If your complaint concerns merchandise ordered by mail, we need copies of both sides of your canceled check.

We may require additional information or prefer to reply by mail; therefore, readers must provide a full mailing address, including ZIP code. Names of letter writers will not be omitted except in unusual circumstances. Letters may be edited for length and clarity.

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