Late Enrollment Penalty for Vet with Credible Coverage

[kencan]

UHC indicated it was for creditable prescription drug coverage which he had .I met with him again because I wanted him to sign the VA authorization for release of information in order to get a copy of the creditable coverage agreement. I am a former caseworker. Thank you everybody for your feedback.

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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.

UHC indicated it was for creditable prescription drug coverage which he had .I met with him again because I wanted him to sign the VA authorization for release of information in order to get a copy of the creditable coverage agreement. I am a former caseworker. Thank you everybody for your feedback.

 

[hassy99]

UHC indicated it was for creditable prescription drug coverage which he had .I met with him again because I wanted him to sign the VA authorization for release of information in order to get a copy of the creditable coverage agreement. I am a former caseworker. Thank you everybody for your feedback.

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UHC indicated it was for creditable prescription drug coverage which he had .I met with him again because I wanted him to sign the VA authorization for release of information in order to get a copy of the creditable coverage agreement. I am a former caseworker. Thank you everybody for your feedback.

I grit my teeth every time I enroll someone who is a va recipient or leaving group coverage. The last couple of years every one in these categories got penalty letters. And it took several months to clear up. Makes me look inept to the client
Mostly the blame is with CMS though because they have to update their system to show previous creditable coverage. But then again a whole lot of blaming going on

UHC mostly

 

[G.Gordon]

I grit my teeth every time I enroll someone who is a va recipient or leaving group coverage. The last couple of years every one in these categories got penalty letters. And it took several months to clear up. Makes me look inept to the client
Mostly the blame is with CMS though because they have to update their system to show previous creditable coverage. But then again a whole lot of blaming going on

UHC mostly

Yep, if you don't make telling them that they will get the letter and don't worry, you are.

I've done two retirees this week, I've told them both to expect the LEP letter and call me when they get it. For future practice, I may get a copy and present it as an example. Just goes to show you are an expert and not "inept". Present the unavoidable.

 

[kencan]

As a postscript, the DOI is following up with me every 30 days until this issue is resolved. All because the client didn't follow my instructions. incidentally, the client disenrolled from the plan in April, 2013.

 

[WCMason]

When I run into LEP appeal entanglements I contact Maximus. Medicare contracts with them to research and resolve these problems. They're great.

http://www.maximus.com/services/federal/health-appeals

 

[hassy99]

When I run into LEP appeal entanglements I contact Maximus. Medicare contracts with them to research and resolve these problems. They're great.

http://www.maximus.com/services/federal/health-appeals

Agreed Nothing seems to happen until they get involved. (3rd party arbitrator)
Given a choice I would just as soon start with them instead of going through all of UHC's process. (That never seems to go anywhere)

 

[swflgal]

Does anyone know the reasoning behind not allowing VA benefits to be considered creditable coverage for Part B? My client declined her part B when she turned 65 because she was using her VA doctors and now can't even enroll in it until this next Jan with an effective date of July 1. Makes no sense to me. Thanks!

 

[DS4]

Does anyone know the reasoning behind not allowing VA benefits to be considered creditable coverage for Part B? My client declined her part B when she turned 65 because she was using her VA doctors and now can't even enroll in it until this next Jan with an effective date of July 1. Makes no sense to me. Thanks!

The "reasoning"? Its the law.

VA health care benefits to Veterans are not creditable coverage for the Part B program.

 

[WCMason]

Does anyone know the reasoning behind not allowing VA benefits to be considered creditable coverage for Part B? My client declined her part B when she turned 65 because she was using her VA doctors and now can't even enroll in it until this next Jan with an effective date of July 1. Makes no sense to me. Thanks!

Medicare was set up so that only active employer coverage exempts someone from late enrollment penalty (and not even all of those). Can't help with the making sense part of that regarding veterans benefits. This is a good illustration of the value of the independent insurance agent focusing on Medicare benefits. It's unfortunate that your client didn't meet you or someone like you sooner.

 

[yorkriver1]

When I run into LEP appeal entanglements I contact Maximus. Medicare contracts with them to research and resolve these problems. They're great.

http://www.maximus.com/services/federal/health-appeals

Just did a search, and the new link seems to be this: DYK MAXIMUS Federal | MAXIMUS
The link in your post was "not found".

Thanks for the heads up to Maximus anyway! It will be a great resource next time late enrollment questions come up, and they will.

Just wrote an MAPD on a client who stayed on ACA plan (I was not the agent then) with spouse after T65 last summer, and didn't enroll in Part B within time required, because ACA "cost a lot less". Client didn't know that was illegal. I helped enroll in LIS last December, then said to call me when Medicare card with Part B issued. The waiting period was still enforced due to late enrollment, but due to LIS, no lifetime penalty. Interesting. I thought maybe they would waive the January to July waiting period, too.