Conundrum and complicated scenario regarding medicare claims for someone who is fully entit

[LazarusW679735]

Hello Folks,

Lately, I have been facing a conundrum and complicated type of situation that one could only attribute to a high level of incompetence and/or disinterest of public employees to deal with any task that fall outside the ordinary (they probably would have to do some search and research, etc).

In reality, it is not my person who is the victim of this never-ending complication and dysfunction while dealing with public employees who work for medicare -- but, for now, I am one who is dealing with it. The victim is my father's ex-wife (like a mother for me, thereof called "mother"). My father is originally from the US, my mother is from Brazil; and they were married for over a decade. Currently both are in their late 70s.

Both my father and mother lived in Brazil, and my mother lived there for basically all her life till recently (moved to the US at beginning of this year [2023] via a green card). She used to come to the US often with a tourist visa to visit though (once a year). On April of 2018 -- when she was already in her 70 -- she was notified by the US consulate that she was entitled to receive social security benefits (small earnings, like U$300) and medicare benefits (was automatically enrolled in medicare part A). There are two major issues and complications that have recently arisen from both her social security and medicare benefits when she started using such benefits (especially medicare).

As pointed out above, she came to the US at the beginning of this year (2023) and then enrolled in medicare part B. It is my understanding that she would have to pay a penalty for have enrolled late. But she should have to pay a penalty of being about 5 years late, since she received the notice from the US consulate of her entitlement to social security and medicare in 04/2018; and not since she was 65 (as is normally the case for people who lived and worked in the US). The penalty being charged goes back to when she was 65, which does not add up since she was not entitled to medicare or social security when she turned 65.

Second, since arriving in the US she went to several medical appointment she since in the US and used her medicare card (plus the part F plan that she has). Few months ago, I started receiving bills from claim that had not been paid by medicare. Once I contacted medicare via phone the attendant indicated that her claims have been denied because she was not legally in the US, which is completely insane and makes absolutely no sense whatsoever. I went to the social security adm. building and presented them with all the documents, etc; they indicated that they had fixed the issue on their side, but then stated that I would have to contact medicare via phone to deal with the medicare part of the problem. Ever since, I called medicare twice and the attendant indicated that they would investigate and would get back to me in week both times -- suffice to say, I still have to hear back from them; and continue to receive medical bills regarding her medicare-covered medical appointments.

At this point, I am not sure on how to procede. Any insights would be appreciated.

[GailL1 · Accepted solution]

When was the last time she renewed her green card?

If this gets corrected with the SSA, it should be correct with Medicare - enrollment in Medicare is always controlled by SSA because they know under what condition(s) one qualifies for the Medicare benefit or not.

THIS is a job for your US Congress-critter -they have staff in their office that work on  stuff like this all the time.  You are gonna have to have some “specific” [meaning personal] type help since this is out of the norm.

Plus the SSA has so many new people working and aren’t trained yet - it is a mess just for the regular stuff - 

Good Luck

[LazarusW679735]

She received her green card in March of this year, so it is perfectly valid. As a green card holder, she has to stay in the country for at least 6 months per year. And she entered in the US with an immigration visa.

"If this gets corrected with the SSA, it should be correct with Medicare"
Yeah, I would assume that too. Maybe some of their employees do not know how to perform their duties properly, especially unusual cases like that.

Thanks for your advice. I was pondering about that possibility: contact my congressmen. Now, it is done: I am dealing with the congressman staff, who them is dealing with medicare and social security.