Late Enrollment Penalty for Vet with Credible Coverage

[kencan]

I enrolled a vet into a Med Advantage plan in Dec., 2011. He received a letter from UHC requestiong evidence that he had credible coverage which he did have (he ignored the letter). He called me in March, 2012 saying he'd received a penalty letter and owed $62. I called UHC who told me he would have to get a letter from the VA saying he had credible coverage I told the client this. In July, 2012 he called to say he now owed $145. He hadn't followed through with my instructions. This time when I spoke to UHC, I was told to have the client contact VA admin and that a verbal attestation was all they needed from the VA.
I gave the client those instructions. Forward ahead to to June , 2013. The state Insurance division called me saying that the client was filing a claim against me! The 1st claim against me in 30+ yrs. I had documented everything and explained that to the investigator.. The client now owes $330. Last week,I met with the client to have him sign off on the VA authorization to release the credible coverage document .I will forward this to UHC.. Hopefully, the late penalty fee can be waived once they receive the document. The client says he will not pay the penalty. Will he still be liable even though he's had the VA coverage since 2002? Thx.

 

[jdeasy]

He can have all the credible coverage he wants but that won't help. He has to have creditable coverage. The VA is considered creditable.

It will most likely be waived once the ducks are in order. he should still have a dumbass penalty but unfortunately there is not one of those.

 

[G.Gordon]

Dumbass penalty does apply.

Another thing, if he filed a complaint against me, there is NO way I'd try to clear up his problem. Screw him. You have records of what you told him to do to fix the issue.

 

[WCMason]

VA is creditable for Part D, so no penalty. But not creditable for Part B. Lifetime penalty.

 

[Stephen]

I can't believe that you met with him again after her called the DOI on you. Did that come up during the meeting?

 

[SportsNut]

I can't believe that you met with him again after her called the DOI on you. Did that come up during the meeting?

Exactly..... I know it would be a CMS violation to speak your mind to a client who filed a complaint like that but one's nature may well take over in that situation. The nerve of some people.

 

[pfg1]

I can't believe that you met with him again after her called the DOI on you. Did that come up during the meeting?

I can''t either. You did everything you could to help this guy and he files a claim against you. Wow.

 

[DS4]

I enrolled a vet into a Med Advantage plan in Dec., 2011. He received a letter from UHC requestiong evidence that he had credible coverage which he did have (he ignored the letter). He called me in March, 2012 saying he'd received a penalty letter and owed $62. I called UHC who told me he would have to get a letter from the VA saying he had credible coverage I told the client this. In July, 2012 he called to say he now owed $145. He hadn't followed through with my instructions. This time when I spoke to UHC, I was told to have the client contact VA admin and that a verbal attestation was all they needed from the VA.
I gave the client those instructions. Forward ahead to to June , 2013. The state Insurance division called me saying that the client was filing a claim against me! The 1st claim against me in 30+ yrs. I had documented everything and explained that to the investigator.. The client now owes $330. Last week,I met with the client to have him sign off on the VA authorization to release the credible coverage document .I will forward this to UHC.. Hopefully, the late penalty fee can be waived once they receive the document. The client says he will not pay the penalty. Will he still be liable even though he's had the VA coverage since 2002? Thx.

Are you referring to the LEP for Part D, or, the 10% penalty for late enrollment in Part B? Because of the $$$$ amounts you are quoting, I'm assuming Part B penalty. If so, your client is F@#fed.

 

[Msann]

Have your client contact Medicare directly, they should be able to clear this up for him. Why is he so willing to report you and for what? With these cases I usually call with the client to Medicare (I've had a few) they're always appreciative of my knowledge and going to bat for them.

 

[jdeasy]

Are you referring to the LEP for Part D, or, the 10% penalty for late enrollment in Part B? Because of the $$$$ amounts you are quoting, I'm assuming Part B penalty. If so, your client is F@#fed.

Good catch. I assumed he was talking part D but it seems that wa s awrong asumption. If it's the part B LEP then you are correct. he's screwed but he only has one person to blame.