Medicare is wrong. Part B start date question... Help?

[sshafran]

Here are the facts...

• Client T65 in November 2018
  
  
• Leaving group coverage 12/31/18
  
  
• We enrolled in Medicare Part A only in November (she did not contact me until then). She had Employer Group Health coverage, and only needs Part A to start - via SSA's website
  
  
• Client sent in CMS-L564E and CMS40B-E in December to local SS office (Specifically, Dec. 2). In bold in the remarks section, "Requested Effective Part B Start Date: 01/01/2019"
  
  
• Faxed MAPD application on 12/20 - reflecting Part A 11/01 (since it would "backdate") and Part B 01/01/19 (since we used SEP for Part B based on leaving employer coverage).
  
  
• A few notes:
  Had we enrolled in November for A&B - it would have started in December. Too Early.
  Had we enrolled in December for A&B - it would have started in February. Too Late.

Client e-mails me today, she received her new card - A shows 11/01 - B shows 02/01. Wrong.

I advise client to call Social Security. She does - they closed at 4pm. So, she then calls Medicare. They said, no, they are right, Part B must start on 2/1/19.

From her e-mail, "They said they did not make a mistake, (and had received my forms,) but because I was in the initial enrollment period and not a special enrollment period, and had waived part B initially, I had to wait 2 months from the time I initially enrolled. The rep also said I did not need to complete the Request for Employment Information. I asked if they could change my effective date to 1/1/2019, but was told ,"no"."

So - forum - I need help. I believe the process followed above was textbook for what should be done to properly start Medicare A & B 2 months post T65.

What do you think I should I do next? Did I make a mistake - or did Medicare? How to fix?

 

[WCMason]

Here are the facts...

• Client T65 in November 2018
  
  
• Leaving group coverage 12/31/18
  
  
• We enrolled in Medicare Part A only in November (she did not contact me until then). She had Employer Group Health coverage, and only needs Part A to start - via SSA's website
  
  
• Client sent in CMS-L564E and CMS40B-E in December to local SS office (Specifically, Dec. 2). In bold in the remarks section, "Requested Effective Part B Start Date: 01/01/2019"
  
  
• Faxed MAPD application on 12/20 - reflecting Part A 11/01 (since it would "backdate") and Part B 01/01/19 (since we used SEP for Part B based on leaving employer coverage).
  
  
• A few notes:
  Had we enrolled in November for A&B - it would have started in December. Too Early.
  Had we enrolled in December for A&B - it would have started in February. Too Late.

Client e-mails me today, she received her new card - A shows 11/01 - B shows 02/01. Wrong.

I advise client to call Social Security. She does - they closed at 4pm. So, she then calls Medicare. They said, no, they are right, Part B must start on 2/1/19.

From her e-mail, "They said they did not make a mistake, (and had received my forms,) but because I was in the initial enrollment period and not a special enrollment period, and had waived part B initially, I had to wait 2 months from the time I initially enrolled. The rep also said I did not need to complete the Request for Employment Information. I asked if they could change my effective date to 1/1/2019, but was told ,"no"."

So - forum - I need help. I believe the process followed above was textbook for what should be done to properly start Medicare A & B 2 months post T65.

What do you think I should I do next? Did I make a mistake - or did Medicare? How to fix?

Because she enrolled the month after her birth month her effective date is delayed one month. So 2/1 is correct for someone born in Nov enrolling in Dec. A Jan. 1 Part B effective date was not available to her no matter when she enrolled.

Because she is still in IEP, the L564 was unfortunately not needed or helpful to her. IEP trumps SEP and Medicare chooses the effective date based on application date and not based on when any other coverage is ending or any other factors.

 

[sshafran]

Because she enrolled the month after her birth month her effective date is delayed one month. So 2/1 is correct for someone born in Nov enrolling in Dec. A 1/1 Part B effective date was not available to her no matter when she enrolled.

Because she is still in IEP, the L564 was unfortunately not needed or helpful to her. IEP trumps SEP and Medicare chooses the effective date based on application date not on date other coverage is ending or any other factors.

.

Wow. That's crazy. So T65 November basically has no option for a January start date.

I feel like a rookie sometimes. I thought we followed the right process.

Thanks.

 

[somarco]

Print this for future reference.

When will my Medicare coverage start?
If you sign up for Part A (if you have to buy it) and/or Part B in this month: Your coverage starts:
The month you turn 65 1 month after you sign up
1 month after you turn 65 2 months after you sign up
2 months after you turn 65 3 months after you sign up
3 months after you turn 65 3 months after you sign up
During the January 1–March 31 General Enrollment Period July 1

When will my coverage start? | Medicare

 

[kak6407]

I have a client that has done something similar although just 1 month out of IEP. He was T65 in sept but had employer coverage through Dec. He enrolled in Part A for Sept and the local SS office is holding his Part B application to submit it on January 2. The lady said that it would back date it to 1/1/19. If she filed it in December (which would still be his IEP) it would have went in to effect 3/1.

I know this isn't same scenario but similar. Very confusing on when you're trying to split the start dates.

In future if they are only looking at delaying 1-3 months my recommendation for my clients may be to just bite the bullet and enroll in both A and B.

 

[T Sparks]

Here are the facts..

Shatfran ,And, you’re wrong. But thanks for playing. We have some nice parting gifts for you...LMAO

 

[sshafran]

Print this for future reference.

When will my Medicare coverage start?
If you sign up for Part A (if you have to buy it) and/or Part B in this month: Your coverage starts:
The month you turn 65 1 month after you sign up
1 month after you turn 65 2 months after you sign up
2 months after you turn 65 3 months after you sign up
3 months after you turn 65 3 months after you sign up
During the January 1–March 31 General Enrollment Period July 1

When will my coverage start? | Medicare

Yes, I knew about that, which is why I thought the SEP was the answer since she wanted Jan 1.

• Enrolling in November = December start date (too early - she needs Jan)
• Enrolling in December = February start date (too late - she needed Jan)

Because of this, we tried to use SEP. Seems like the SEP should be available.

The fact that the SEP is trumped, null, and void, simply because of her being in her IEP - is what I was not expecting.

Over 500 medicare clients, and this is the first time I ran into this - someone needing Medicare to start 2 months after T65. That's also weird - that I've never run into this before.

Whoever created the system - is on drugs.

 

[sshafran]

Shatfran ,And, you’re wrong. But thanks for playing. We have some nice parting gifts for you...LMAO

I've been talking about the nice forum mug as a parting gift for a while now - perhaps Sam can mail me one now.

 

[somarco]

He's not so nice any more . . .

and I (EP) comes before S (EP)

I tell folks I can only tell them how it works but can't explain the logic behind Meducare rules.

Because it isn't logical.

I have had other situations where a T65 wants to delay Part B for a month or so but don't believe I have ever had a Nov T65.

 

[Todd King]

.

Wow. That's crazy. So T65 November basically has no option for a January start date.

I feel like a rookie sometimes. I thought we followed the right process.

Thanks.

It's all because she delayed the enrollment. If she had not done that then things would have worked normally.