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Valued Social Butterfly

Re: Medicare Part B Coverage Limbo

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Message 1 of 6

@rthomure

Yep, welcome to government "helping" you - I was hoping SHIP could at least explain what is happening in your specific situation.    So much for what AARP, Medicare, etc. recommends that you do.

 

I think if this was an "everybody" problem - we would be hearing more about it here or even in the real media.

 

Since General Enrollment applications are now in the process - Jan 1 - March 31 - you should ask SS if they are processing your application under General Enrollment or Special Enrollment?

You would have had it long ago (July 2017) if under SEP, IMO.

 

I really think it has to do with that COBRA - and if that is the case you may have to pay a Part B penalty.  I still do not understand how COBRA got involved.

 

You are without Medicare Part B coverage right now - right?  And if under General Enrollment, you won't have it until July 2018. 

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Info Seeker

Re: Medicare Part B Coverage Limbo

3,358 Views
Message 2 of 6

Gail1

Thanks again for your help.  I did contact our state SHIP office and received the following response -

 

Hi Randall,
If SSA is working to correct the issue, then there is nothing more that our State agency, can do.
If the SSA system is rejecting your registration, then I would guess that is happening to others, as well.

The only thing I can think of is to contact your congress person’s local office. However, I don’t know how that can be expedited, if it is a system problem.
 

John Marruffo, MSEd, MS, MBA | Staff Development Specialist
Illinois Department on Aging
Senior Health Insurance Program (SHIP)

 

 

New Day - New Year - same problem.  I'm just not use to dealing with government agencies - coming from private industry; we stressed results and accountability.  In government, it is actions by committee with no clear path of ownership.  I've never be accused of being too patience, so being required to wait for something to happen by somebody(ies) is not in my DNA.

 

Sorry to vent  - but this costing me an ordinate amount of time and money. 

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Valued Social Butterfly

Re: Medicare Part B Coverage Limbo

3,414 Views
Message 3 of 6

I don't understand why you got COBRA coverage?

If you worked until June 2017 and already had Part A, why not just pick up Part B during the SEP.

 

Did you provide Medicare/Social Security with documentation that you were working and had employer coverage until June 2017 - not COBRA, employer coverage - and that employer coverage had ended.

 

Government in this regards does not consider COBRA an employer plan because the let go for whatever eligible reason employee does not have to take it and they pay all the premiums.

 

The COBRA coverage, I believe, seems to be the problem.

 

 

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Info Seeker

Re: Medicare Part B Coverage Limbo

3,420 Views
Message 4 of 6

Gail,

Thanks for the quick response.  

I believe that I did qualify under the Special Enrollment Period [SEP] since I continued to work full time and was covered under my employer's health insurance plan thru June, 2017.  The Social Security office did confirm that I meet the requirements of the SEP.  As per the information on Medicare.gov 

 

"You also have an 8-month SEP to sign up for Part A and/or Part B that starts at one of these times (whichever happens first):

  • The month after the employment ends
  • The month after group health plan insurance based on current employment ends

Usually, you don't pay a late enrollment penalty if you sign up during a SEP."  

 

I retired in at the end of June, 2017 at the age of 68.  There is a lot of encouragement from the government and others to continue working past the normal retirement date.  Unfortunately they don't tell you that their systems get confused when people try to do things outside the norm.  I signed up for Medicare Part A when I turned 65, like required.  It was my understanding that I could delay signing up for Part B until I was no longer covered by my employer's health insurance, which occured in July, 2017.  Now it seems that Social Security's system is rejecting my Part B registration for reasons unknown to me or the Social Security people at the Chicago office. 

 

One additional "gotyah"  is that Social Security and Medicare treat COBRA coverage different from the employer's insurance coverage.  Although I'm still technically enrolled in my former employer's health plan as allowed under COBRA, according to Medicare/Social Security; I no longer are covered under their defintion.  I guess that what it means when it states "after employment ends".  So yes that what it says, but it would nice and helpful if they would just simply state, "Continuation under the former employer's health plan under COBRA does not consitute coverage for purposes of enrollment during the SEP period" or something like that.  It is another example of how insurance companies and govement agencies wording provides information but doesn't actually provide clear direction.  It would be nice if it is understandable for the non-lawyers in the room.  Maybe a warning to others that could be caught under similar circumstances would be helpful. The note you provided was helpful, but I didn't see it on the Medicare.gov website.

 

The problem that I have is that for some reason Social Security can't seem to get the registration through their system.  It has gone on for 6 weeks now and I don't know where to turn.  Any direction would be helpful.

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Valued Social Butterfly

Re: Medicare Part B Coverage Limbo

3,440 Views
Message 5 of 6

Without all the specific dates, I can only guess but it sounds like you missed your Special Enrollment Period and opted for COBRA instead. Now you are in the General Enrollment Period and if this is the case, you will be doing good if you can avoid paying the LATE ENROLLMENT PENALTY - forever!

 

Medicare says this Medicare.gov - Part A & Part B Sign Up Periods

 

Initial Enrollment Period:

When you're first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B.

 

Special circumstances (Special Enrollment Periods)

Once your Initial Enrollment Period ends, you may have the chance to sign up for Medicare during a Special Enrollment Period (SEP). If you're covered under a group health plan based on current employment, you have a SEP to sign up for Part A and/or Part B anytime as long as:

  • You or your spouse (or family member if you're disabled) is working.
  • You're covered by a group health plan through the employer or union based on that work.

You also have an 8-month SEP to sign up for Part A and/or Part B that starts at one of these times (whichever happens first):

  • The month after the employment ends
  • The month after group health plan insurance based on current employment ends

Usually, you don't pay a late enrollment penalty if you sign up during a SEP.

 

NOTE

COBRA and retiree health plans aren't considered coverage based on current employment. You're not eligible for a Special Enrollment Period when that coverage ends. This Special Enrollment Period also doesn't apply to people who are eligible for Medicare based on having End-Stage Renal Disease (ESRD).

 

General Enrollment Period:

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.

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.

 

In most cases, if you don’t sign up for Medicare Part B when you’re first eligible, ( or during your special enrollment period) you’ll have to pay a late enrollment penalty. You'll have to pay this penalty for as long as you have Part B and could have a gap in your health coverage.

 

Medicare says this about the Part B Late Enrollment Penalty

Medicare.gov - Part B Late Enrollment Penalty

 

So, it sounds like they are keeping your Part B application for the General Enrollment period of January 01 - March 31 but your coverage for Part B will not start until July 01.

AND sounds like there will be a penalty for late enrollment.

 

Perhaps you should talk to Social Security and play ignorant - don't know if that will help for most people.  Maybe, if you are low income and might be able to get some special help.

 

I do not know how detailed on the different Enrollment Periods this Medicare Calculator gets for your situation but you might be able to try it - it does say it is NOT for all situations. 

Medicare.go Eligibility and Premium Calculator

 

Why all the rules - they get more pennies for not following the rules.

 

If I am wrong about this situation, run your perdicament with all the details by your State Health Insurance Assistance Program rep - Find them by putting in your state on this Medicare site.

Medicare.gov - Find your SHIP

 

Hope this helps in explaining what I think is going on - sure sounds like it.

If I am right, I am sorry to have to bring you some bad news on a News Years Day -

 

 

 

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Medicare Part B Coverage Limbo

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Message 6 of 6

I'm needing some assistance getting Medicare Part B started.  In November, November 17,2017 to be exact, I filed for Medicare Part B at the local Chicago Social Security office.  As of this date, January 1, 2018; I still do not have Part B coverage. The local S-S office confirmed all paperwork has been properly filed, but it is a problem with their system that keeps rejecting the registration.  

 

I have talked with several people at the S-S local office.  They assured me that it will be addressed "soon".  Although "soon" hasn't happened, my almost daily calls to the office go to voicemail and have not been returned.  

 

I retired effectively in  July, 2017; electing to continued to work past both normal retirement age and past Medicare start date.  Since my retirement, I continued to pay for COBRA coverage, very expensive.  Since I'm unable to confirm coverage under Medicare Part B, I'm unable to secure a Medicare Advantage plan from Atena or other insurance company.

 

Medicare says it's not their problem.  Social Security office is "working on it" and will be resolved "soon".  Does anyone know how I can escalate this problem to get it resolved?  Any help would be greatly appreciated.

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