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Part B reapply question

Long story, I guess. I was retiring at the end of April and both my wife and I were covered under my company group insurance. She receives SSDI, is 63 years of age, and applied for Part B in mid-April under a SEP (covered by a group health plan through my employer). Part B began in May. Our group health plan coverage ended at the end of April and they told we each had to phone SS and let them know we were no longer insured by them. She did this in June, but there was some goof up and somehow she was dis-enrolled from Part B.

 

Our talks with SS have lead no where except them saying she can reapply for Part B either during a SEP or the yearly enrollment period at the start of next year. So, here's a dumb question--does it seem logical that she could just turn around and reapply now, since she actually was in one SEP when she first applied for Part B (i.e., still insured) in April; and now could enroll within the next 8 months under the SEP related to our leaving the group insurance coverage (midnight of the last day of April)? Since both occurred about the same time (applied in mid-April for Part B and also dropped group insurance the end of that month), I don't know if this will work and may have to talk to SS..

 

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@DuaneK761357 your story is interesting but as @GailL1 pointed out, there seem to be some missing pieces.

 

Our group health plan coverage ended at the end of April and they told we each had to phone SS and let them know we were no longer insured by them. She did this in June, but there was some goof up and somehow she was dis-enrolled from Part B.

 

WHO told your wife to call SSA regarding loss of coverage?

 

Follow this link to learn more about applying for Part B following loss of EGH

https://www.ssa.gov/disabilityresearch/wi/medicare.htm#work

 

The process for applying for Part B following loss of EGH (employer group health) was covered in @GailL1 post.

 

If not, she will have to complete form CMS-40B

and have the employer complete form CMS L564

 

40B is the paper application for Part B, L564 is the required form if you want immediate coverage without delay or penalty. Both forms SHOULD be sent to SSA at the same time  to minimize the chance of the forms becoming lost in the maze.

 

The 8 month rule in @GailL1 post allows you to enroll in Part B ONLY IF your wife did not apply for COBRA. Applying for COBRA shortens the 8 month window to 63 days.

 

If 40B and L564 were never submitted to SSA do so now. It is possible SSA will accept these forms and retroactively approve Part B.

 

Otherwise she will have to wait until the GEP (General Enrollment Period) next January, apply for coverage which will become effective July of that year. A lifetime late enrollment penalty will apply.

 

Hope this helps.


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somarco  and Gail.1,

Her clinic told her to do it. Also, she did not apply for COBRA.

 

Anyway, thanks for all your help. We will complete the two forms (as we did when she applied back in April while we did have group coverage), and submit under the 8 month window.rule for loss of Group Health Plan. If she doesn't get accepted for some reason, it's just a long time to be without good insurance.

 

 

 

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@DuaneK761357 if you have copies of 40B and L546 try submitting them along with your NEW form (fresh dated). Include a cover letter explaining what happened . . . got B then "lost" B. Someone @ SSA might have pity on you and reinstate.

 

The "clinic" did not do any favors for your wife by telling her to call SSA. I really hate it when someone gets bad information that sends them down a rabbit hole.

 

If you can find an SSA office near you that is open that is preferable. Sitting down with a human better than relying on a voice on the phone. If you have to go through it long distance these guidelines might help.

https://www.medicare.gov/blog/coronavirus-medicare-enrollment

 

Regarding L546:

 

f you have Medicare Part A (Hospital Insurance) and you’re eligible to enroll in Medicare Part B (Medical Insurance) through a Special Enrollment Period (SEP), you have options for how to apply. You can complete the Part B SEP online or you can mail your completed CMS 40B, Application for Enrollment in Medicare - Part B (Medical Insurance) and CMS L564 - Request for Employment Information to your local Social Security office. You’ll also need to send any required proof of employment, Group Health Plan (GHP), or Large Group Health Plan (LGHP) coverage. You can also fax your enrollment forms and evidence of employment to 1-833-914-2016. Your employer doesn’t need to sign Section B of the CMS L564 form. State “I want Part B coverage to begin (MM/YY)” in the remarks section of the CMS 40B form or the online application.

https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS009718


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Honored Social Butterfly


@DuaneK761357 wrote:

Long story, I guess. I was retiring at the end of April and both my wife and I were covered under my company group insurance. She receives SSDI, is 63 years of age, and applied for Part B in mid-April under a SEP (covered by a group health plan through my employer). Part B began in May. Our group health plan coverage ended at the end of April and they told we each had to phone SS and let them know we were no longer insured by them. She did this in June, but there was some goof up and somehow she was dis-enrolled from Part B.

 

I have to ask a couple of questions about your wife's coverage before answering your question.

Since she is only 63 years of age - has she been on SSDI for the required 24 months to qualify for Medicare?

Did she already have Part A  or did Medicare accept her Part A enrollment when she applied for both Parts A & B in mid-April?

It just seems like something else is going on here.

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She started Part A back in 1998. I had employer group insurance so she never grabbed Part B until I retired thIs year. It is unfortunately possible that she did dis-enroll without comprehending what she was doing as she did the phone call to SS..

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@DuaneK761357 

 

OK, then there should be no problem with her enrolling in Part B NOW - She is already in her special enrollment period.  You will have to remember we are not in normal times due to Covid-19 - many of these people are working remotely - it helps to do it their way albeit the government way is sometimes a bit more complicated.

 

Try it the requested way, MAYBE it would work better.

Social Security.gov - Apply Online for Medicare Part B During a Special Enrollment Period 

Medicare Part B Enrollment During the COVID-19 Pandemic:

Can you handle this digital method?

If not, she will have to complete form CMS-40B

and have the employer complete form CMS L564

 

-------------------------------------------------------------------------

Here is the Medicare rule on the subject -

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

 

To sign up for Part B, complete an Application for Enrollment in Part B (CMS-40B).

Special circumstances (Special Enrollment Periods)

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

 

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

 

When the employment or employer/union coverage ends:

 

. . . . You have 8 months to sign up for Part B without a penalty, . . . . . To sign up for Part B while you're employed or during the 8 months after employment ends, complete an  Application for Enrollment in Part B (CMS-40B) and a Request for Employment Information (CMS-L564).

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