How to Appeal a PDP Late Enrollment Penalty?

[sam816]

A client got a statement from UHC showing a CMS imposed late enrollment penalty of $31 per month, where does he need to go in order to appeal this penalty, local social security office or calling CMS?

TIA.

 

[LostDollar]

https://www.medicare.gov/part-d/costs/penalty/part-d-late-enrollment-penalty.html

This says the appeal has to go to UHC. I don't know if there is a direct to CMS appeal.
(Note the language on Medicare.gov. It says the plan imposes the penalty and CMS calculates it.)

When I enrolled in SilverScript, they wanted a penalty, even though I had supplied all the info to CMS and enrolled in Part B penalty free. I had to give it all to SilverScript again. To get it resolved, I did it over the phone, A customer service person completed all the forms there directly into the computer.

 

[TwoCents]

A client got a statement from UHC showing a CMS imposed late enrollment penalty of $31 per month, where does he need to go in order to appeal this penalty, local social security office or calling CMS?

TIA.

Likely if UHC didn't send a request for proof of creditable coverage, they weren't the ones to impose the LEP and the client had one previously. I'm guessing UHC isn't his first Part D (PDP or MAPD) plan. If that's the case, then appealing through UHC likely won't net any results. He'd want to ask how to appeal through Maximus (CMS contractor). Likely though, he's missed any appeal deadlines depending on the real age of the LEP.

 

[LostDollar]

More hunting-this turned up:

https://www.cms.gov/Medicare/Appeal...riev/Late-Enrollment-Penalty-LEP-Appeals.html

 

[vic120]

https://www.medicare.gov/part-d/costs/penalty/part-d-late-enrollment-penalty.html

This says the appeal has to go to UHC. I don't know if there is a direct to CMS appeal.
(Note the language on Medicare.gov. It says the plan imposes the penalty and CMS calculates it.)

When I enrolled in SilverScript, they wanted a penalty, even though I had supplied all the info to CMS and enrolled in Part B penalty free. I had to give it all to SilverScript again. To get it resolved, I did it over the phone, A customer service person completed all the forms there directly into the computer.

sound like you had to do an attestation which is common when someone retires late than age 65.

If there is a penalty you get a bill for premium plus penalty, I had a client took him 6 months to fix a penalty he should not have recieved

 

[LostDollar]

sound like you had to do an attestation which is common when someone retires late than age 65.

If there is a penalty you get a bill for premium plus penalty, I had a client took him 6 months to fix a penalty he should not have recieved

Was he working with the plan provider or with CMS (or both) to accomplish that?

 

[vic120]

Was he working with the plan provider or with CMS (or both) to accomplish that?

It was about 3 years ago but I think he was dealing with Social Security, He had to send document's FU resend documents take record of who he spoke with what time and day and resend documents before it was done

 

[DS4]

A client got a statement from UHC showing a CMS imposed late enrollment penalty of $31 per month, where does he need to go in order to appeal this penalty, local social security office or calling CMS?

TIA.

Was he coming off an employer plan after age 65? If so, he will receive a questionnaire from the Part D ins co.
A $31 LEP is about 86 months worth of penalty.

 

[sam816]

Was he coming off an employer plan after age 65? If so, he will receive a questionnaire from the Part D ins co.
A $31 LEP is about 86 months worth of penalty.

He was on group plans for a number of years after turning 65, the problem is he did not keep good records of what coverages he had and when they ended.

 

[WCMason]

He was on group plans for a number of years after turning 65, the problem is he did not keep good records of what coverages he had and when they ended.

I have found Maximus to be helpful to the beneficiary, especially if there are multiple employers and the beneficiary is unable to track down proof of the creditable coverage