Archive for the ‘Real Stories About Medicare’ Category
The day before Thanksgiving I received a call from Barbara. She has been enrolled on Medicare part A for years. She recently lost her job and elected COBRA, continuation of medical insurance coverage, from her former employer. This recent event triggered a letter from the Human Resources of her former employer. The letter is written in a confusing language of insurance and Medicare. It is difficult to decipher, unless a person knows the rules, and understands the connection between employer based medical insurance and Medicare.
The first relevant rule is the election of COBRA benefits that makes Medicare primary over the COBRA based medical insurance. The second rule, in her situation, is the special enrollment period.
Barbara had to contend with her special enrollment, along with a crazy New York insurance law that allows insurance companies to pay only 20% of Medicare fee schedule, when seeking medical care. If she decide not to enroll on Medicare part B, she will be responsible for 80% of the same Medicare fee schedule. (Medicare fee schedule is based on the government complex calculation for medical services.)
Medicare’s enrollment is administered by the Social Security office, therefore Barbara called the office to request enrollment on Medicare part B. She was told that they could send her the forms, but they have to be filled out and postmarked no later than November 30. They do not send anything by FedEx or UPS. At the suggestion of the telephone helper, she wrote a letter to SSA stating that she wanted to get Medicare part B. Then, she went to deliver it personally and waited about an hour until her number was called. Barbara spoke to a person who insisted that she get a form, providing exact date of termination, signed by her former employer. She had spent 1.5 hours in the SS office, and then she sent the form by UPS overnight to her former employer with a return paid UPS label addressed to her. The clerk explained that he needs this date to know when to start Medicare part B. Her full Medicare coverage may start on November 1 or December 1. The Social Security clerk gave a date stamp on Barbara’s letter with his signature, which she has to bring back with the HR letter on Monday.
I hope Barbara will have her letter; therefore, she will have Medicare part B next month.
I additionally hope that at some point our federal lawmakers will step back and see the monstrosity, and unnecessary burden they are creating for people whom already earned Medicare enrollment.