She left the country after applying for medicare - can she re-enroll when she comes back ?

[LeeC678785]

I am discussing a situation for a elderly family member.

She left USA in May 2019 and requested withdrawal her medicare application. Somehow that request was not honored instead they partially dis-enrolled her. Only part A was dis-enrolled ..part B is still continuous and medicare is asking her to pay premium until Nov. 30 2019. She is planning to send a letter to SSA to dis-enroll from part B as well as  part D.(envision rx plus)

Question is...if she decides to come back to USA after lets say 3 months from now ..can she enroll again under special enrollment clause? (Becuase she is returning to USA from other country) is this a valid reason for enrollment under speical enrollment? 

If not when can she get enrolled in medicare again....(ofcourse after returning to USA)

[GailL1]

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@LeeC678785 wrote:

I am discussing a situation for a elderly family member.

She left USA in May 2019 and requested withdrawal her medicare application. Somehow that request was not honored instead they partially dis-enrolled her. Only part A was dis-enrolled ..part B is still continuous and medicare is asking her to pay premium until Nov. 30 2019. She is planning to send a letter to SSA to dis-enroll from part B as well as  part D.(envision rx plus)

Question is...if she decides to come back to USA after lets say 3 months from now ..can she enroll again under special enrollment clause? (Becuase she is returning to USA from other country) is this a valid reason for enrollment under speical enrollment? 

If not when can she get enrolled in medicare again....(ofcourse after returning to USA)

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To give you a simple answer - most likely she will have to pay a Part B premium penalty if she cancels it and then moves back. 

I will try to help you with your question in more detail but I am going to have to make some assumptions -

• I will assume that when she signed up initially that she was at the age and under the conditions where she was suppose to sign up.  IOW, she was 65 years of age and did not have employer / union coverage still or staying in affect.
• I will also assume that she worked long enough and paid into the Medicare Part A system long enough so that her Part A was to be received premium free.
• Since she may or may not come back here - this may or may not be considered as travel rather than a move.
• I am also assuming that US Medicare is her primary system of benefits and that she does not have dual citizenship somewhere else where she maybe eligible for the other country's system.

Wish she had just kept her Part A coverage since for most people this coverage is premium free - if vested in the program by years of working under the system.

Now to give you some details:

To dis-enroll in Medicare Part B once enrolled takes an interview and a specific paperwork completion - they do this for a purpose - to make sure you know what you are doing and any possible consequences.

SSA: FAQ - How do I terminate my Medicare Part B (medical insurance)?

There are certain times when traveling when Part B can be used.

Medicare.gov - Travel Medical Coverage

There may be even instances where Medigap coverage can be used while traveling.

Medicare.gov - Medigap and Travel

If you do so and do not have a specific good (sanctioned) reason (meaning that perhaps you have or are getting coverage through your employer if you are going back to work or have some other type of sanctioned / approved / credible coverage as determined by SSA).

Once Part B and Part D is cancelled and she decides to come back and reinstate them - most likely she will have to pay the premium penalty for at least Part B -

Medicare.gov - Part B late enrollment penalty

Medicare.gov - Part D late enrollment penalty

She may or may not be assessed a Part D late enrollment period - reason being is the "SEP".

Medicare.gov - Special Circumstances (Special Enrollment Periods)

Please notice carefully how these Special Circumstances are worded:

You can make changes to your Medicare Advantage and Medicare prescription drug coverage  when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP.

I moved back to the U.S. after living outside the country.

What can I do?

Join a Medicare Advantage Plan or Medicare Prescription Drug Plan.

When?

Your chance to join lasts for 2 full months after the month you move back to the U.S.

If she decides to come back and opts for original Medicare (as opposed to a Medicare Advantage plan) and she wants a Medigap plan to help with her medical cost under original Medicare, she may not be able to get a Medigap plan or if she does, it could be very expensive depending upon her health / age / geographical location.

Everybody pays a Part B premium regardless of whether or not they choose to have original Medicare or a Medicare Advantage Plan - so most likely she will definitely have to pay a penalty for this Part B coverage when and if she returns after it has been cancelled.

Seems her main decision is to decide where she wants her retirement roots to be -

[LeeC678785]

Thanks for detailed reply but it still does not answer the question ..whether she can re-enroll under special enrollment ? or she can only enroll during Jan 1 to March 31 2020 open enrollment period?

[GailL1]

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@LeeC678785 wrote:

Thanks for detailed reply but it still does not answer the question ..whether she can re-enroll under special enrollment ? or she can only enroll during Jan 1 to March 31 2020 open enrollment period?

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Since she will be signing up for Medicare Part A and B outside of her initial enrollment period - The General enrollment period is January 1 - March 31 but her coverage will not start until July 1.

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

If she cancels Part B - and comes back and re-enrolls in Part A and Part B - she will have to pay a premium penalty forever on the Part B premium.

[LeeC678785]

I dont think you read my question throughly. 

I said they heve dis-enrolled her from part A and part B and D still on.

That means she has already signed up during initial enrolment.

Next I asked if moving to USA after about 3-4 months qualifies her for special enrollment.

Everyone knows that she can reenroll during open enrollment.

Please answer to what I ask ...if not ..please stay away.

[GailL1]

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@LeeC678785 wrote:

I dont think you read my question throughly. 

I said they heve dis-enrolled her from part A and part B and D still on.

That means she has already signed up during initial enrolment.

Next I asked if moving to USA after about 3-4 months qualifies her for special enrollment.

Everyone knows that she can reenroll during open enrollment.

Please answer to what I ask ...if not ..please stay away.

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Sorry if there is confusion - Medicare is not a simple system when things happen out of the ordinary.

Here ya go - strait from the horses' mouth, so to speak - perhaps this will help.

Medicare.gov Publication: Enrolling in Medicare Part A & Part B

SEE Section 2 Page 28

I believe you said that she has disenrolled in Part A already and will disenroll from Part B at the end of November 2019 - she has already used her "initial" enrollment since it is a very limited specific time and she diisenrolled; there is no do-over for the initial enrollment.

Thus she has to use the General Enrollment period when she wants to pick Part A and Part B back up again.  She does not qualify for a "Special Enrollment" period UNLESS ( you didn't say) she has other (SSA/Medicare) sanctioned, credible coverage while she is out of the country and will drop that coverage when she comes back to the US to pick up her Parts A & B (again).

General Enrollment is Jan 1 - March 31 every year and then coverage does not start until July 1.

This situation is  the closest to her situation from the above link:  ( see page 28 )

Situation #2: If you live outside of the U.S., you’re over 65, and you’re eligible for Social Security benefits, you may file an application for monthly benefits and Part A. You’ll have to file for Part B during the General Enrollment Period. This period runs from January 1 – March 31, and you may have to pay a late enrollment penaly.

If you have further questions about this situation, you can contact Social Security on Medicare Benefits.  SSA: Medicare Benefits

"If you do not live in the U.S. or one of its territories you can also contact the nearest U.S. Social Security office, U.S. Embassy or consulate.

[LeeC678785]

She will dis-enroll from part B this month. But what if she wants to come back to USA in lets say December so she will be without coverage for almost 4 months. 

With medicaid (state health insurance) she was able to get on health insurance whenever she would come back to USA. That is what I thought she it should be same with medicare.

At present she has health insurance in India but that not sure if its approved by medicare(how do I know that?) 

Further you said general enrollment ...does she need to be physically present in USA at the time of enrollment? or she can enrollment on phone or via mail or worst at consulate office in India? I am asking this because she does not want to be here when she does not have coverage ..so for example she comes to USA in month of feb. 2019 and enrolls but she will not have coverage until July 1 so for few months she would not have coverage. 

[LeeC678785]

Again ..you not listening.

Here was my main question..

oes she need to be physically present in USA at the time of enrollment? or she can enrollment on phone or via mail or worst at consulate office in India? I am asking this because she does not want to be here when she does not have coverage ..so for example she comes to USA in month of feb. 2019 and enrolls but she will not have coverage until July 1 so for few months she would not have coverage. 

I strongly suggest ..dont respond to my questions.

If you have plenty of time on hand ..use it for others.

[GailL1]

Read the links that I have provided - especially the last ones.

I am done !

[GailL1]

Medicare.gov - Signing up for Parts A & Part B Out of the country

This might be helpful - 

Medicare Interactive - Medicare coverage when living abroad

This sounds like she should not have cancelled Part A or Part B

from the link ~

You may want to keep Part B if you plan to move back to the U.S. in the future or visit frequently. This is because paying the premium to keep Part B when abroad will ensure that Medicare will cover your care whenever you travel to the U.S., and that you will not face premium penalties or gaps in coverage.

If you fail to pay for Part B while abroad, when you move back to the U.S. you may go months without health coverage. This is because you may have to wait until the General Enrollment Period (GEP), which runs January 1 through March 31 each year, with coverage starting July 1.

If you fail to pay for Part B while abroad, when you move back to the U.S. you may go months without health coverage. This is because you may have to wait until the General Enrollment Period (GEP), which runs January 1 through March 31 each year, with coverage starting July 1.

If you have a Medicare Advantage or Medicare Part D plan before you move abroad, you should disenroll and stop paying these premiums when you move because these plans require that you live in their service area in order to be enrolled.

Note that this information only applies if you are living abroad; it does not apply if you are simply taking a trip. If you have specific questions, contact the Social Security Administration (800-772-1213) or the Consulate or Embassy in your country of residence before making any final decisions about Medicare enrollment.

She was probably on Medicaid before she turn 65 and eligible for Medicare.

A person cannot just move in and out of Medicare without problems happening -

Is this moving from here to there and then there to her gonna be an ongoing thing?

I don't understand why she dis-enrolled in Part A - normally, it is premium free. And if she was planning on coming back realatively soon - why disenroll from Part B.  Sounds like she didn't want to pay the Part B premiums  and that could be a mistake depending on when she is returning.

She will have to talk to a foreign country services - there is contact info (embedded link) at the above link. OR if they cannot help, perhaps send a letter to the Social Security (Medicare) office in DC asking about her situation particularly about having health coverage in India and whether or not they consider it credible coverage.

That's all I have - think she made a mistake cancelling her Part A and Part B - cancelling a Part D plan -  No problem.   If she had a Medicare Advantage plan and cancelled it - NO problem

It is the Part A and particularly the Part B coverage and timing that is gonna be the problem.