Late enrollment penalty issue

[vic120]

I have a client retired at 68 in nov Part B 11/1 did a 12/1 with humana
He got a letter to do attestation he filled it out and sent it back

But they sent him a letter stating he has a $12 and change penalty
So when he calls they say sorry they have no record of anything
Nothing they can do
and nothing he can do
but he now has penalty for life and will not listen to anything he says

what can we do?

 

[hockeyday]

I have a client retired at 68 in nov Part B 11/1 did a 12/1 with humana
He got a letter to do attestation he filled it out and sent it back

But they sent him a letter stating he has a $12 and change penalty
So when he calls they say sorry they have no record of anything
Nothing they can do
and nothing he can do
but he now has penalty for life and will not listen to anything he says

what can we do?

Go on Vantage and upload a copy of the document he sent them, also it to your humana rep

 

[Special Agent]

I have a client retired at 68 in nov Part B 11/1 did a 12/1 with humana
He got a letter to do attestation he filled it out and sent it back

But they sent him a letter stating he has a $12 and change penalty
So when he calls they say sorry they have no record of anything
Nothing they can do
and nothing he can do
but he now has penalty for life and will not listen to anything he says

what can we do?

This is why i always tell people to call and verbally attest and also send it in.When verbally attesting it is processed in real time and there is a record of the call.

He may have to do an appeal with Maximus or call his congressman office believe it or not they will help with situations like this.

 

[somarco]

Was he without creditable drug coverage for more than 63 days?

If so, the $12 would not be a late penalty, but I have no idea what a "change penalty" is nor do I know how it would be for life. If anything, it is probably a one time fee, not a penalty.

 

[LostDollar]

Was he without creditable drug coverage for more than 63 days?

If so, the $12 would not be a late penalty, but I have no idea what a "change penalty" is nor do I know how it would be for life. If anything, it is probably a one time fee, not a penalty.

I think he is saying the actual penalty amount is $12 plus some amount of cents, giving a total > $12, but < $13.

 

[LostDollar]

I have a client retired at 68 in nov Part B 11/1 did a 12/1 with humana
He got a letter to do attestation he filled it out and sent it back

But they sent him a letter stating he has a $12 and change penalty
So when he calls they say sorry they have no record of anything
Nothing they can do
and nothing he can do
but he now has penalty for life and will not listen to anything he says

what can we do?

Caveat, not an agent.

If this is a PDP, and he does not have a gap > 63 days between end of employer coverage and the start of the Humana PDP, he should be able to do the attestation over the phone with a Humana CSR. If Humana won't do that, then I think gathering the coverage info and doing an appeal would be the best bet. Maximus, or whatever the appeal organization is, can bring more oomph to the issue than you or your client can if Humana is choosing to be very difficult.

 

[LostDollar]

I thought Maximus might be an older appeal organization.

Here is what I find when I search about Part D lep appeals.

Late Enrollment Penalty (LEP) Appeals | CMS

An overview of a late enrollment penalty (LEP) assessed when a Medicare beneficiary had a continuous period of 63 days or more at any time after the end of the individual's Part D initial enrollment period during which the individual was eligible to enroll, but was not enrolled in a Medicare...

www.cms.gov

You can see if other agents have had clients use this particular form for appeal.

 

[Special Agent]

I thought Maximus might be an older appeal organization.

Here is what I find when I search about Part D lep appeals.

Late Enrollment Penalty (LEP) Appeals | CMS

An overview of a late enrollment penalty (LEP) assessed when a Medicare beneficiary had a continuous period of 63 days or more at any time after the end of the individual's Part D initial enrollment period during which the individual was eligible to enroll, but was not enrolled in a Medicare...

www.cms.gov

You can see if other agents have had clients use this particular form for appeal.

Maximus Biggus Dickus ?

 

[TwoCents]

For what it's worth Humana sends out the initial attestation and a reminder so client should have had an inkling that something was wrong. Not defending the Big H, but wanted to throw this out there.

Special Agent is on target about how the client should have double submitted.