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Gender: Do not display
Current location: TN
Member since: Fri Aug 19, 2005, 09:23 AM
Number of posts: 14,220

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Help with Medicare?

It doesn't look like this group is very active, but I'll try anyway.

I am disabled and became eligible for Medicare years ago. However, I opted out of Part B because I was covered under my husband's employer's group plan. His most recent employer closed up shop suddenly and unexpectedly in January, causing us to lose our group coverage. He signed up on healthcare.org, but I am not eligible to do that because I am disabled and eligible for Medicare.

I immediately went to my local Social Security office, which takes applications and faxes them to Social Security, to apply for Medicare Part B. After waiting 3 months, I called the national number on Monday and was told that my application was denied. The only reason given was "not an enrollment period" and was told to re-apply. When I called the local field office, they said I need to appeal.

It was my understanding that I am eligible for a special enrollment period because I have maintained group coverage all these years and lost coverage unexpectedly. There is a form to be filled out by the employer stating this. I was able to get the form from the most recent employer, but could not get one from the previous one because they had been bought several times during the course of my husband's employment and the final buyer/employer does not keep employee records that far back. Social Security advised me to submit letters of creditable coverage from the insurance companies, which I did. There was no gap in coverage at any time.

As fas as I can tell, I did not do anything wrong. But they never sent a letter of denial or information on what they need. I have been without healthcare, except for Medicare Part A, since February 1 and have since run up some bills at some Doctor's offices. Now it looks like it will be another 3 months, after a I figure out what I need to do, before they will start coverage and hopefully backdate it to February. Even if they do that, I could be charged a stiff penalty if they don't accept the letters from the instance companies as proof of group coverage during all that time.

Does anyone know what to do? It's not like you can talk to anyone who makes the decisions. I wish they would just pick up the phone and call if they see a problem, rather than inefficiently requiring another long process involving paperwork and lots of calls to the call center.

On a side note, this is a perfect example of why Republicans hate government. Yes, I have Republican friends who could only reply, "yeah, that's the government for ya" when I told them about it. It would be great if we could do something to streamline this process, as well as all the other processes that seem to be so bogged down in bureaucracy that they waste a lot of taxpayer money.
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