Medicare muck

[fostever]

I have a situation where a person turned 65 in August 2008 and social security sent the wrong form which delayed the part B effective date and sent her confirmation of the part B effective date in October stating part B was effective Sept.1, 2008. So I returned to her house to sign her up with an MAPD plan in October for a November 1,2008 effective date. Well the application was rejected by Medicare stating that since Parts A & B started at separate times the 60 day rule goes into effect which states she must sign up 60 days before Medicare B becomes effective. I submitted a copy of the letter and her Medicare card along with the app just to be on the safe side and they still rejected. After calling Medicare they said that the application should have been accepted due to IEP extending 90 days after her initial enrollment month. Then why did they send the rejection letter back to the MA plan? It seems many of the people working for Medicare don't even KNOW the rules. Boy, I can't wait until the government gets involved in universal healthcare!!

 

[Frank Stastny]

I have a situation where a person turned 65 in August 2008 and social security sent the wrong form which delayed the part B effective date and sent her confirmation of the part B effective date in October stating part B was effective Sept.1, 2008.

This is the part of your post I'm confused about.

I'm not sure what form you are talking about. I'm asking because I have never run into this.

The only way she would not automatically receive both Part A and Part B is she has elected not to draw Social Security. Is that what happened?

I have had several people elect to draw SS benefits at a later date and I have recommended to them that they simply go to the SS office and sign up for Medicare.

 

[The Rabbi]

61% of all calls to Medicare result in misinformation. I get frustrated with ins companys CSRs and ask for a supervisor. It's hard to get good help when no one really cares about their job. There are some real dummies answering the phone.

 

[Dave020]

Correct me if I am wrong on this, but isn't the rule for MAPD 3 months prior and the month OF Part B eligibility?

That would mean she had June, July and August for the 90 days prior and the month of September to enroll.

I think you missed the cutoff for MAPD.

She does have a 6 month window GI for a supplement starting Sept 1 so you could put her on a supplement until Jan 1 then use the open enrollment to move her onto an MAPD.

 

[jdeasy]

Correct me if I am wrong on this, but isn't the rule for MAPD 3 months prior and the month OF Part B eligibility?

That would mean she had June, July and August for the 90 days prior and the month of September to enroll.

I think you missed the cutoff for MAPD.

She does have a 6 month window GI for a supplement starting Sept 1 so you could put her on a supplement until Jan 1 then use the open enrollment to move her onto an MAPD.

A person that enrolls in part B when they are first eligible for part B has a 7 month window for MA. MAPD, or PDP. 3 mos. prior to getting part B, the month they get part B and 3 mos. after.

If a person does not take part B when first eligible, but takes it at a later date, they are not eligible for an ICEP. They have an SEP for 63 days upon getting part B.

From what I gather from the first post, the claim is that the person's ICEP was lost due to an error by SS or Medicare. What I'm not understanding from the poster is why there is a problem. Even if was an error and part B was effective on Sept. 1, 2008, we are still within that 63 day window.

 

[Dave020]

Got it, thanks. Sups are 6 months from Part B eligibility date going forward.

 

[G.Gordon]

We had a ton of shady agents slamming people into CIP around here. Some for conditions as minor as hypertension... nothing else. Some thought it was just a drug plan. Some didn't know what the heck happened to them. How does this relate...

Upon getting a call from these folks and educating them of what they actually had done most wanted to return to traditional medicare. Upon calling medicare with them to use a SEP to exit the plan I'd have to tell have the CSR's to read all of the rules pertaining to SEP's aftering arguing that they didn't need to wait till the AEP to exit. I think the rule that applied was like the fourth or fifth one on their list, but they'd stop reading on #1 which pertained to the AEP.

Yea.. government healthcare. Can't wait till I can retire and move to Mexico.

 

[retread]

We had a ton of shady agents slamming people into CIP around here. Some for conditions as minor as hypertension... nothing else. Some thought it was just a drug plan. Some didn't know what the heck happened to them. How does this relate...

Upon getting a call from these folks and educating them of what they actually had done most wanted to return to traditional medicare. Upon calling medicare with them to use a SEP to exit the plan I'd have to tell have the CSR's to read all of the rules pertaining to SEP's aftering arguing that they didn't need to wait till the AEP to exit. I think the rule that applied was like the fourth or fifth one on their list, but they'd stop reading on #1 which pertained to the AEP.

Yea.. government healthcare. Can't wait till I can retire and move to Mexico.

Your point illustrates both sides of the problem. Missing in the discussion was the complicity of the insurance carriers. I don't know if you are certified with UHC or not, but I just took their on-line training and certification for 2009 a couple of days ago, and I was insulted. This year's material was presented at a grade-school level! It wasn't that hard last year as I remember, but this year's used graphics usually found in 2nd or 3rd grade school classes. It seems that the carriers, afraid that agents couldn't pass with an 85% score, so they made the tests easy enough for a 5th grader!

As long as carriers recruit agents that are intellectually challenged, we are going to see more and more crazy things, no matter how hard CMS tries to crack down. You just can't legislate stupidity.