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Periodic Contributor

Is there an alternative to Medicare Part B?

Hi, I'm here in sunny Florida and recently retired at 66.

 

Because I wasn't given good advice I applied for Medicare after the deadline. As a funny result, I'm entitled for the Part A immediately (actually I was given a past starting date) but not for the Part B until half a year later. 

 

Now I have no insurance for doctors appointments. Is there any affordable insurance for covering these 5 months gap of doctors?

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Contributor

Check with those who are experts in handling Mediclaims on your behalf.

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Bronze Conversationalist

@VivanR142934 is there an alternative to Part B?

 

Short answer, NO.

 

Nor will you find anything comparable to the overall value you get from original Medicare.

 

I am uncertain what "Mediclaims" are, but I have been working with health insurance / Medicare clients for over 45 years. I understand the claim process and how you need to have a basic understanding of how health claims work if you don't want to get hammered on OOP expenses.


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@BartolomeM 

 

You can sign up for Part A and/or Part B during the General Enrollment Period between January 1–March 31 each year if both of these apply:

You didn't sign up when you were first eligible.
You aren’t eligible for a Special Enrollment Period (see below).


You must pay premiums for Part A and/or Part B. Your coverage will start July 1. You may have to pay a higher premium for late enrollment in Part A and/or a higher premium for late enrollment in Part B.

https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b/part-a-part-b-sign-up-periods


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Periodic Contributor

Hi Somarco, thanks for copy-pasting the content of the Medicare web page that legally supports my lack of insurance. And yet, still no solution for the gap created by the rules of enrollement. Fact is, I cannot visit a doctor until July 1st!

Bronze Conversationalist

@BartolomeM I cannot visit a doctor until July 1st!

 

You can receive any kind of outpatient care before July 1 . . . but those claims will not be covered by Medicare Part B.

 

I can't find it now, but reasonably sure providers who ACCEPT Medicare patients are limited in how much they can charge a patient even when that patient does not have Medicare. Doctors who accept Medicare patients are subject to a limiting charge. If the doctor has opted out of Medicare they are not subject to those rules.

 

Keep in mind that Part B is MORE than just doctor visits. It also includes MRI, CT, X-ray, ER, ambulance, lab . . . 

 

I am curious who gave you the "bad advice" about skipping your initial enrollment period for Part B.


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Periodic Contributor

Hi Somarco. 

Sorry for my delay, but I was travelling and I couldn't access this section from the app.

 

The "bad advice" came this way.

I didn't want to misunderstand the information on the website, so that I visited the local Social Security offices to learn about the steps to get Medicare.

 

I had ACA by then. After reviewing my case the agent asked me when I was willing to apply. My answer since I turned 65 already and had no employer insurance was as soon as possible. That was May. Then the misstep came. In stead of informing me that because of the deadline for registration had passed I wouldn't be able to get the Part B until one year latter... she just said, OK, let's apply now then. That was not in written, just a conversation.

 

A month later I was granted Medicare Part A since the past January and Part B since July 1... of the following year!

 

Since you "can not receive federal help through two ways" I lost the ACA and was left in the limbo. 

And yes, you got it: what is more expensive are not the doctors, but labs and MRI's that are accessible through Part B.

 

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Honored Social Butterfly

@BartolomeM 

 

I don't see any "bad advice" from the SS rep - you applied for coverage when you applied (May 2019) - months after your initial Part B enrollment period ended and months after the General Enrollment period in 2019 (January - March).. 

Medicare.gov - Part A & Part B sign up periods 

 

Your ACA plan should have given you fair warning about dropping your coverage when you turned 65 in, I believe, January 2019. 

 

I assume you had no coverage at all for any services between Feb. 2019 and May 2019 until SS initiated your Medicare Part A coverage and backdated it to your 65th birthday - January 2019.

 

Just try to stay healthy; don't do any dare-devil stuff, try to avoid accidents - in other words, live in a bubble until July 01, 2020 cause even though you have Medicare Part A coverage - most of the time, you go thru some Part B services 1st before getting to Part A needed services.

Medicare Part A - What's Covered 

 

Sorry

It's Always Something . . . . Roseanna Roseannadanna
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Honored Social Butterfly


@BartolomeM wrote:

Hi, I'm here in sunny Florida and recently retired at 66.

 

Because I wasn't given good advice I applied for Medicare after the deadline. As a funny result, I'm entitled for the Part A immediately (actually I was given a past starting date) but not for the Part B until half a year later. 

 

Now I have no insurance for doctors appointments.

Is there any affordable insurance for covering these 5 months gap of doctors?


Not that I am aware of - but maybe one of the professionals who come to this board occassionally may have some ideas.

 

as you know, your Part B coverage will start on July 1 unless you meet one of the "Special Circumstances"  that opens up a Special Enrollment Period.

Medicare.gov - Part A & Part B sign up periods 

 

What coverage have you had since turning 65???  Employer?  ACA? 

Who gave you the faulty advice and if someone professional/official, do you have it in writing?

Details might be considered by Medicare but it depends on the details and how hard you want to fight for this if applicable at all.

 

It sounds from your post that you may also have to pay a Part B late enrollment premium penalty which will last forever.  Think that will be about $ 14 a month.

 

 

 

 

 

It's Always Something . . . . Roseanna Roseannadanna
Periodic Contributor

Hi Roseanne, Thanks for your replay. Yes, I had ACA coverage that I lost because of the Medicare enrollement. I cannot get ACA for Doctors (Part B) because "I can't get help from the government through two ways." 

Moreover, I didn't find yet any private insurer that could offer this service.

So, as somebody said "I'm in the limbo..."

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Honored Social Butterfly

@BartolomeM 

 

You said you were already 66 years old; Medicare starts at 65 - so you are a full years late in signing up.  

 

Where did did you get the bad info ?

 

Medicare.gov - Medicare & the Marketplace 

 

Did you not get any info from your ACA insurer that the ACA plan and any premium tax credit subsidies you might be getting to help with your premiums would END when you turned 65?  

 

Because of what happened, there is no way that Part B will begin before July 01   - you will just have to pay out of pocket if you need to see a doc before then or any other Part B covered services.

 

Actually, that may be just one important matter.  Another is the Medicare

Part B premium penalty that you will forever have to pay.  And you may have a hard time getting a Medicare supplemental , if you want one, because underwriting will be in play.  

 

You cannot even join a Medicare Advantage plan or I think, a Medicare Prescription Drug program until you have Part B.

 

from the above Medicare.gov link:

 

Once you’re eligible for Medicare, you’ll have an Initial Enrollment Period to sign up. For most people, the Initial Enrollment Period starts 3 months before their 65th birthday and ends 3 months after their 65th birthday month.

Once your Medicare Part A coverage starts, you won’t be eligible for a premium tax credit or other savings for a Marketplace plan.

If you kept your Marketplace plan, you’d have to pay full price. For this reason, in most cases, you’ll want to end your Marketplace coverage once you’re eligible for Medicare. You may get a notice from the Health Insurance Marketplace that says you may soon be eligible for Medicare & can change your Marketplace plan. Don’t wait for the notice. Be sure to sign up for Medicare once you’re eligible.

 

Hope you don't get a big surprise when you do your taxes this year (for 2019).  If you were getting an ACA premium tax credit.

 

I am sorry this has happened to you.  How did it happen cause there should have been some failsafes.  When did you lose the ACA coverage?

 

Healthcare.gov - Changing from Marketplace Health Insurance to Medicare 

 

 

It's Always Something . . . . Roseanna Roseannadanna
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