At the end of last year, Russell M. retired from federal service. Upon his retirement, he switched to the Compass Rose Health Plan. He was looking forward to working with a company that easily coordinated with Medicare and had a nationwide network, making traveling with his wife more enjoyable. Retirement was going to be great!
Unfortunately, things did not start off well for Russell. When he retired, his employer lost his paperwork to change health plans — twice. This caused a delay in the switch between plans and his former employer gave him some advice to use his old insurance card. This caused a claims payment nightmare.
When Russell received health care services, he was no longer covered by his old plan and his claims were denied, getting rebilled to the Compass Rose Health Plan. Russell was spending almost eight hours a day on the phone trying to get bills squared away. That is when the Compass Rose Health Plan stepped in to help out this new health plan member.
The Compass Rose Health Plan called Russell’s providers and old health plan on his behalf, allowing Russell to get back hours a day on the phone so he could enjoy his retirement. “Working with Compass Rose has been phenomenal,” he said.
On top of navigating his claims, the Compass Rose Health Plan helped coordinate his prescription transfers with Express Scripts. With the help from UMR and Express Scripts themselves, “I get [my medications] when I’m supposed to,” Russell said. “The people I talk to at Express Scripts and UMR have been super.”
Retirement is supposed to be a time of celebration of lifelong achievements and duty to service — not an insurance nightmare. The Compass Rose Health Plan believes health insurance coverage is more than a monthly premium and is readily available to help whenever needed. Before switching to our health plan, Russell was averaging $2,500 a year just in copayments. He averaged $0 last year with the Compass Rose Health Plan.
“Now that the kinks are ironed out, I can’t believe how smooth things are going,” Russell said. Now retired, he enjoyed his first vacation with his wife in over two years and continues to enjoy the unwavering support from Compass Rose that makes his retirement even better.
When your child is in pain, you would do anything to help them feel better. That is what Compass Rose Health Plan member Mike M. wanted for his daughter.
Mike’s daughter needed to have surgery to relieve her pain. Her original appointment was not set for weeks, but they were presented an amazing opportunity to get an earlier appointment — only two days away — due to a cancellation. “She was in pain, so the sooner the procedure could happen, the better,” Mike said.
Following the typical pre-surgery process, the physician’s office submitted the prior authorization request. However, Mike knew things needed to move quickly so he called Compass Rose for reassurance. After hearing Mike’s situation, senior leadership at Compass Rose Benefits Group personally stepped in to ensure the necessary steps were taken for his daughter. She needed this treatment soon to relieve herself of this pain and Compass Rose was on a mission to make sure it happened.
By noon the next day, all the paperwork was complete. Mike’s daughter had the surgery and it was hugely successful. “My daughter is doing very well and I am thankful to Compass Rose for treating me like family,” Mike said. “Their commitment to members is exceptional.”
Mike has been a health plan member for over 38 years. “Being a Compass Rose Health Plan member gives me and my family peace of mind that when I need support, they will be there.”
At Compass Rose Benefits Group (CRBG), we feel it is our duty to step up and help our members in good times and tough times. Such was the case for John R., a member at CRBG for over 50 years. When John’s wife experienced life-threatening complications from Hepatitis C (Hep C) and Parkinson’s Disease over the years, the people at Compass Rose stepped in to help, with hands-on assistance that was timely and essential for Mary, John’s wife.
Mary was diagnosed in the late ’90s with Hepatitis C, a condition that was traced back to tainted blood she received from an operation in 1975. In late 1998 and 1999, Mary underwent an experimental chemotherapy procedure that showed promise in curing Hep C, but in this case, the treatment resulted in a worsening of Mary’s condition.
For several years Mary continued to have regular blood tests to monitor her Hep C. In 2004, things got a bit more complicated as she was diagnosed with Parkinson’s Disease. After reviewing Mary’s medical tests and blood work, doctors recommended she visit the Mayo Clinic for an evaluation and additional testing. The hope was that these new tests would result in additional treatment options that could significantly improve Mary’s health.
At over 65 years of age, Medicare was now her primary insurer. The approval for the tests were initially denied by Medicare so John reached out to the Compass Rose Health Plan. He needed help and was not sure where to turn. Compass Rose stepped in and told John to take Mary to the Mayo Clinic and that Compass Rose would cover at least 90% of the cost.
In December 2007, Mary received the tests and evaluation from the Mayo Clinic. John was relieved and astonished – ”We never had to pay a penny for all the tests taken at the Mayo Clinic. The Compass Rose Health Plan picked up all the costs that Medicare would not cover.”
Mary improved but had another setback in 2015. Mary’s on-going blood work started showing some alarming changes. Her liver was not functioning properly, which can be life-threatening. Doctors prescribed a new drug called Harvoni and wanted to start immediately. Once again, Medicare denied the request. The Compass Rose Health Plan intervened and approved paying for the cost of the medication, which was in excess of $90,000 for a 90-day supply.
“My total cost was $575.11 for the 90-day supply of the medication, which was going to be over $30,000 a month,” exclaimed John. After taking Harvoni, Mary was Hep C FREE! There have been many blood tests since and Mary still shows no signs of Hepatitis. Her liver is no longer in the danger zone.
John’s closing pronouncement is the one that is most important to the people at Compass Rose Benefits Group: “Without Compass Rose, my wife would not be alive today.”
Compass Rose Benefits Group is here to help — today, tomorrow and well into the future. Our members are our family and we treat them accordingly. The benefits at Compass Rose go way beyond what is listed in a policy. If you need help with the complexities of the insurance landscape, we are always here to provide the support you need.
Mary, a Compass Rose Health Plan member, has Parkinson’s Disease and, after a number of falls, was admitted to the Heritage Hall Nursing Home in early 2019. Unfortunately, her condition had progressed where it affected her mobility and she needed extra care to live a safer life.
During the first month at the nursing home, her husband John was having trouble ordering two of her Parkinson’s medications through Express Scripts. If he was not able to fill the prescriptions in time, Mary would run out — he needed this issue resolved ASAP. Needing extra help during this hard time, John reached out to Compass Rose directly to see what could be done to speed up the process.
After answering the call, Compass Rose Benefits Group stepped in right away and recognized the critical importance of these medications for John and Mary. Two hours later, Mary’s medications were at the airport for shipment and arrived in their hands the next day.
“It was through the efforts of this senior manager at Compass Rose Benefits Group that I received the medication in less than 24 hours after my call to her,” John said.
Compass Rose Benefits Group will do anything to help members in need.
When life puts you in tough situations, it can be hard to navigate them alone — especially if they involve a loved one. However, our members and their families never face hard situations by themselves.
When John B.’s mother had a stroke, he was given power of attorney relating to her health care. He needed to submit a claim for reimbursement to settle payments between his co-pay and amounts already paid for a quite expensive drug.
Luckily, John’s mother has been a Compass Rose Health Plan member for many years. He had the best team on his side. “The Compass Rose staff was very patient and listened as I explained [my issue],” John said.
After speaking with the Compass Rose Health Plan, John received all of the answers he needed. “The respect, courtesy and professionalism shown to me were above and beyond,” he said. Compass Rose is always ready to help members in times of need so they can make decisions confidently.
There is always something special for every Compass Rose Health Plan member. As lifelong members, Erika and her husband have enjoyed Compass Rose’s low co-pays and deductibles for over 50 years. However, they are now enjoying the newest program created for members over 65 years old: Aging Well.
Through the Aging Well program, members can speak with Compass Rose team members about nutrition, respite care and other challenges and pleasures about growing older. While speaking with our resource coordinator, Erika mentioned the challenges of living at home with her husband in a wheelchair. We knew it was our duty to help.
“I wanted to get [my husband] a lift chair so that he could sit comfortably during the day and even take a nap,” Erika said. Unfortunately, Medicare would only pay for the “lift” component and not the chair. That was not in Erika’s budget.
The next day, Compass Rose called Erika back with life-changing news. Compass Rose Benefits Group’s charity would help fund the chair for her husband. But the help didn’t stop there. Compass Rose helped Erika find a Medicare-participating medical equipment supplier and helped negotiate a price that would work for her budget.
Within a few days, the chair was delivered. “This has improved my husband’s quality of life tremendously,” Erika said. This is another example of Compass Rose going above and beyond for members, solidifying Erika’s view that “there is no better company around.”
The experiences of the individuals described herein may not be representative of the experiences of all members.