Part B upon leaving employer, Part D requiring creditable coverage notice?

[yorkriver1]

Probably a duh, just missing that connection right now. Just enrolled the person to get it done Part A only now, showing loss of employer coverage 12/1/23. That will trigger a request for creditable coverage notice, for sure, but if waiting until Part B for 12/1/23 finalized still the proof of coverage, I think. Maybe I am just in OE/AEP overload, lol

 

[Chazm]

I keep reading this but I can’t understand the question. I’m prob in AEP dumb mode too

 

[billyb]

My wife's Part A was effective 5/1/21. She worked until May 28th of this year. Was told her employer coverage would expire 9/30. In June she tried to apply for Part B online but was told to go to the office in FWB. Sat for 2 hours and thought everything was taken care of.

In July got a letter telling her to apply in September. She started calling around mid August and finally got approval for Part B in late September. Not sure why the paperwork she gave them in June didn't work. It was a hassle but she got it done.

 

[somarco]

Probably a duh, just missing that connection right now. Just enrolled the person to get it done Part A only now, showing loss of employer coverage 12/1/23. That will trigger a request for creditable coverage notice, for sure, but if waiting until Part B for 12/1/23 finalized still the proof of coverage, I think. Maybe I am just in OE/AEP overload, lol

Too many moving parts that can create delays. I tell folks that Murphy is alive and roaming the halls in DC so don't be surprised at delays.

I will assume this person worked past 65 so this is not your customary T65 situation, but rather an SEP based on loss of creditable coverage.

Part A MAY be backdated up to 6 months. Usually that is not a big deal unless the prospect is making HSA contributions.

CMS 40B and L-564 should be submitted at the same time. Use the REMARKS section of 40B to request a specific effective date for Part B to begin, otherwise Medicare will pick a date of their choosing.

I don't recall ever needing a creditable coverage certificate for Part B, only for Part D, and even that is rare. Most of the time the PDP carrier simply asks for an attestation stating that the creditable drug plan ended on x/x/2023.

The hangup happens when SSA gets bogged down and can't process applications on a timely basis. I have seen Part B processed in a week or so to 3 months.

So much is hurry up and wait so you and your client have to be flexible.

 

[yorkriver1]

I already wrote the PDP with a LEC SEP for 12/1/23, the end date the employer coverage is over. I was just wondering if he had his Part B showing in the system (applied for but not showing yet), if new to Part B would waive the need for the PDP to ask for creditable drug coverage. Thanks Bob for the simplification, I always tell the client to look in their employee benefits portal for the Creditable Drug Coverage notices their employer is mandated to provide. I do have word that other forms of proof are OK with the PDP's.
Won't be doing the MedSupp app until the Part B shows in the system. The carriers will usually wait a varying # of days after the plan's requested start date for the Part B to show up, but I don't like to push that too far.

 

[yorkriver1]

I already wrote the PDP with a LEC SEP for 12/1/23, the end date the employer coverage is over. I was just wondering if he had his Part B showing in the system (applied for but not showing yet), if new to Part B SEP would waive the need for the PDP to ask for creditable drug coverage. Thanks Bob for the simplification, I always tell the client to look in their employee benefits portal for the Creditable Drug Coverage notices their employer is mandated to provide, or ask HR/Benefits dept or in some cases the group insurer. I do have word that other forms of proof are OK with the PDP's.
Won't be doing the MedSupp app until the Part B shows in the system. The carriers will usually wait a varying # of days after the plan's requested start date for the Part B to show up, but I don't like to push that too far.

 

[Truce]

My experience has been that if the Part D insured has used an SEP for LEC, the insurer automatically will send the self attestation of creditable coverage form to avoid the LEP. The part B enrollment, lack of enrollment, in process enrollment doesn't factor. And if they aren't new to Medicare since they already have Part A, why would it?

Yes the Part B and Med supp timing thing is a pain. Many times (usually involving employer forms faxed to the local office) I tell people I will check the system on the last day of the month and if the Part B isn't apporved, we will submit the app anyway and try for a retro date. If it goes to the next month, and they have a claim, hopefully it's just a DR visit that goes toward the Part B deductible anyway.

 

[somarco]

@yorkriver1

Get Your Medicare Number Before Card Arrives

Log in to your MySSA account and look for a link labeled View Benefit Details under the Benefits and Payments section. Click the link and scroll down to Your Benefit Determination Letter. Click that link and it will open a window with a Benefit Letter. You can save and/or print the letter. Scroll down about 3/4 of the way and will see your Medicare number.



THIS is what you are looking for after logging into your SSA account



Welcome, Your Name!
You last signed in on November 17, 2022 at 3:04 PM ET.

Your Social Security Statement

You can download your statement as a PDF or an XML file.

Your Benefit Verification Letter

This is your proof of income letter.


If you are receiving SSA benefits that information will be on page 1 . . . keep scrolling to page 2 where you will see this . . .


You are entitled to medical insurance under Medicare beginning (month, year) .

Your Medicare number is (11 digits, combination letters and numbers) . You may use this number to get medical

services while waiting for your Medicare card.

 

[TwoCents]

Probably a duh, just missing that connection right now. Just enrolled the person to get it done Part A only now, showing loss of employer coverage 12/1/23. That will trigger a request for creditable coverage notice, for sure, but if waiting until Part B for 12/1/23 finalized still the proof of coverage, I think. Maybe I am just in OE/AEP overload, lol

Let me see if I understand what you're trying to say. The client already has Part A for however long since you don't give any dates other than 12/1/23. With Part A only the client is eligible for a PDP. Let's say the client's IEP ended last year 8/31/22, but continued to carry creditable drug coverage through work.

Whenever the client joins a Part D plan, the creditable coverage clock starts back at 9/1/22. The client should get a request from the Part D plan asking for an attestation that the client had creditable coverage going back to the end of the IEP. No documentation should be required; just fill in the form and return or call the info into the plan.

Can you take a breath before posting next time? Sheesh.