Retirees' Newsletter

Faculty and Librarian Retirees' Association, University of Windsor

Jan/Feb. 1995 Issue 11

ARTICLE ON MEDEX WAS "INACCURATE", SAYS FLORIDA OFFICIAL; BUT JIM SKINNER STANDS HIS GROUND

A REPORT IN THE LAST ISSUE of The Newsletter (Nov/Dec '94) caused ripples which reached to Florida and back.

THE REPORT HAD SAID that, according to comments by Jim Skinner to the Association's Fall meeting, "many Florida hospitals now won't recognize our Medex coverage, demanding their money up front".

Blake Gertz, a Bus. Admin. retiree, who lives in Port St. Lucie, Fla., took the report to the office of his local member of the Florida House of Representatives, Mr. Ken Pruitt. Rep. Pruitt in turn relayed it to Florida's Secretary of Commerce, Mr. Charles Dusseau.

Mr. Pruitt expressed doubt about the accuracy of the report, and added that "this type of misinformation could have a serious adverse impact on Florida's tourism". Pruitt asked that the Commerce Secretary give serious attention to the matter.

WAS THE REPORT INACCURATE ?

As indicated above, Jim Skinner, the U's Manager of Benefits and Pensions, first brought the matter to the attention of our Fall meeting, the basis of the original report. Mr. Skinner backed up his contention in a recent letter to the editor of The Newsletter:

"From personal experience, I was told by a hospital employee that unless the Insurance Company has a business office in the United States, Florida Hospitals as a rule would not honour the Medex Coverage. The patient would have to pay up front, and be reimbursed by Medex directly". Skinner added that at least two

University employees have had difficulty in Florida using this coverage.

Blake Gertz informs us from Florida that "in actual fact each hospital decides for itself whether or not to accept the insurance". He and Rep. Pruitt contacted two hospitals and found that those two do accept, provided 50% of the (estimated) fee is paid in advance.

Blake added, by the way, that in both those cases the billing departments told him that Medex is very slow to pay claims. Further, he will keep us informed of any other action which the Florida Department of Commerce takes on the matter.

A SOLUTION, OF SORTS

Writing to The Newsletter, January 20th, Skinner revealed that at least a tentative solution has been achieved by Green Shield. Members travelling in Florida should note.

"I have been informed by Jim Mousseau", said Skinner, "that Medex has set up a network of hospitals across Florida who will honour (the Green Shield Medex) coverage. If a member becomes ill, they should dial the 800 number on their card and they will be directed to the nearest hospital which honours Medex. This is not perfect but perhaps, after my contact with Ken Pruitt, a better solution can be arrived at". We'll report further.

MEMBERSHIP CARDS

Each member should receive with this issue a membership card for the the Retirees' Association. To save costs, the Sec'ty-Treas. printed them on his laser printer, the same one that does The Newsletter. He said this was in keeping with his budgetary rule of thumb, viz. 'parsimony at all costs', adding that at some future date something more elegant might be found to lie within our grasp. Fata viam invenient, intoned the s-t.

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