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I called 1-800-MEDICARE today to find out when to enroll my husband for Medicare part B and D before incurring penalties for enrollment beyond the special periods.
The agent whom I talked to confirmed my understanding of the followings:
1. The special enrollment period for part B is within 8 months from the last date of coverage by an employer's insurance plan.
2. The special enrollment period for part D is within 63 days from the last date of coverage by an employer's insurance plan.
I also learned that the coverage takes place about a month after the enrollment.
Our situation is that I have my employer's insurance coverage until November 30th, 2015. As part of the severance package, my employer will pay for 4 months of COBRA premium. This means we will need to pay for own insurance (COBRA or ACA for me and Medicare part B & D for my husband starting April 1, 2016 or earlier to ensure continuous coverage and no penalties.)
Since the special enrollment period for part D is only 63 days from November 30, 2015, my husband will need to enroll for Medicare part D before the end of January, 2016.
With up to 8 months for part B and with the coverage starts around 1 month after enrollment, my husband can wait until end of February or early March to enroll for coverage to start April 1, 2016 when the free COBRA coverage ends.
I am posting here hoping to get confirmation from others who had done similar plans & for 'real world' feedback on how long that it takes for coverage to start after enrollment during the special period.
First of all, kudoes to you for taking the time to gather information now, so that you know what is the best step for you and your husband later in the year!
I would also suggest that you keep a notebook where you write down all the questions you need to get answered -- leave a space for the answers, and note who you talked with, date and time. I'd also call one or more resources and ask the same questions, and compare the answers. The things you are researching are potentially big financial matters, and one or two answers that are wrong can make a huge difference in the resources the two of you have in retirement. I've heard of people who kept such a notebook, wrote down the name and operator number of each person they spoke with at Medicare, Medicaid, etc., and the date and time, and what that person said. Sometimes if they give you bad information, and you still have your notebook, you can file an appeal and Medicare has to give you the resources needed, because you are able to prove that you sought out information from their staff, and were given wrong information. But you have to take good notes, and be able to show dates and times of conversations, as well as identify the staffer you spoke with (you won't get a last name, but you can get an operator number).
Your question is basic and important, and I'm bemused to say that I'm not entirely certain of the right answer. I definitely don't want to give you wrong information. So I'll point you to a few resources that I'm sure can help:
a. The Medicare Rights Center is a national non-profit that advocates for the rights of people with Medicare. They are not affiliated, funded or controlled by Medicare, and they have a national 800 hotline and a website. Here is their contact information:
c. Are you going to be eligible for "Extra Help" to help defray his out of pocket costs for medications? This program is run by the Social Security Administration. Check out their website for eligibility levels and a simple, on-line application.
d. Am guessing that you're in Washington State. Do you know about the discount drug card? Don't know if this is of use to you, but if you want more info, here's a link: http://www.fuzeqna.com/pdp/ext/kb17-...e-program-spap
e. If your husband is a veteran, the VA has a drug program which can also lower his drug costs -- and he can benefit from the drug program even if he'd prefer to get his medical care elsewhere than the VA. They also have a hearing aid program that can make a huge difference -- I was amazed at the cost of hearing aids.
Good luck with your search, and let us know if there are additional questions we can field.
Last edited by Inquring81; 10-26-2015 at 08:25 PM..
2. The special enrollment period for part D is within 63 days from the last date of coverage by an employer's insurance plan.
I also learned that the coverage takes place about a month after the enrollment.
Our situation is that I have my employer's insurance coverage until November 30th, 2015. As part of the severance package, my employer will pay for 4 months of COBRA premium. This means we will need to pay for own insurance (COBRA or ACA for me and Medicare part B & D for my husband starting April 1, 2016 or earlier to ensure continuous coverage and no penalties.)
Since the special enrollment period for part D is only 63 days from November 30, 2015, my husband will need to enroll for Medicare part D before the end of January, 2016.
If the employer's insurance includes prescription drug coverage, that drug coverage will carry over to the COBRA plan. This gives the COBRA plan "creditable drug coverage." The special enrollment period (SEP) for Part D would start when COBRA ends.
Quote:
COBRA can be considered creditable coverage for purposes of Medicare Part D. Thus, if an individual has prescription drug coverage through a COBRA plan that is considered "creditable" (at least as good as what he or she can get through a Part D plan), the individual has a SEP to enroll in a Part D plan at the end of COBRA coverage, without a waiting period and without a penalty.
I would also suggest that you keep a notebook where you write down all the questions you need to get answered -- leave a space for the answers, and note who you talked with, date and time. I'd also call one or more resources and ask the same questions, and compare the answers. So I'll point you to a few resources that I'm sure can help:
a. The Medicare Rights Center is a national non-profit that advocates for the rights of people with Medicare. They are not affiliated, funded or controlled by Medicare, and they have a national 800 hotline and a website. Here is their contact information:
Thank you very much for great suggestions and links to other sources to verify the information.
The agent whom I talked to seemed a bit inexperience but was sincere in trying to help. She told me to wait for few minutes while she was trying to verify some information. I assumed that she has a rule books to go by but it appeared that she missed the part about part D as pointed out by SCGamecock.
We are currently residing in NY and plan to move to Washington state or Idaho in the near future.
My husband is not a vet. He got sent home with his crutches (he broke his ankle in a car accident shortly getting the draft card) when reported to the board in the 60's.
Quote:
Originally Posted by SCGamecock
If the employer's insurance includes prescription drug coverage, that drug coverage will carry over to the COBRA plan. This gives the COBRA plan "creditable drug coverage." The special enrollment period (SEP) for Part D would start when COBRA ends.
Thank you very much for the link to this correct information about part D. This means we don't have to apply for part D early. Interestingly enough, I got the information about 63 days period for part D from my now 'previous' employer. Maybe they want to reduce the Cobra cost in the 4 free months period.
Thank you very much for great suggestions and links to other sources to verify the information.
The agent whom I talked to seemed a bit inexperience but was sincere in trying to help. She told me to wait for few minutes while she was trying to verify some information. I assumed that she has a rule books to go by but it appeared that she missed the part about part D as pointed out by SCGamecock.
We are currently residing in NY and plan to move to Washington state or Idaho in the near future.
My husband is not a vet. He got sent home with his crutches (he broke his ankle in a car accident shortly getting the draft card) when reported to the board in the 60's.
SCGamecock,
Thank you very much for the link to this correct information about part D. This means we don't have to apply for part D early. Interestingly enough, I got the information about 63 days period for part D from my now 'previous' employer. Maybe they want to reduce the Cobra cost in the 4 free months period.
63 Days is the deadline to pay for your first premium for COBRA. I'm wondering if either they are NOT offering Plan D to you during your severance time or if they were just misinformed.
There has to be an easier way to distribute Medicare....WAY, WAY too many different deadlines to consider.
63 Days is the deadline to pay for your first premium for COBRA. I'm wondering if either they are NOT offering Plan D to you during your severance time or if they were just misinformed.
There has to be an easier way to distribute Medicare....WAY, WAY too many different deadlines to consider.
My bad! I did not spend the time to read the ENTIRE letter about my prescription drug coverage and Medicare. I was just focusing on the 63 days period which is significantly different from the 8-month for part B so I decided to call Medicare to verify.
This morning, I reread the letter carefully and it did provide the correct information. Here is the pertinent part: "xxx has determined that the prescription drug coverage offered by our medical plans expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage...... you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
I totally agree that there ought to be an easier and less confusing way to distribute Medicare. Why there are different special enrollment periods for part B and D and why there are different rules with Cobra not considered 'creditable' coverage for part B but it could be considered creditable for part D.
In addition, no where that I can find the information on how far in advance that one has to apply for Medicare to ensure that the coverage starts at a certain date. I also don't know if one can apply ahead and specify the date for the coverage to take place.
My bad! I did not spend the time to read the ENTIRE letter about my prescription drug coverage and Medicare. I was just focusing on the 63 days period which is significantly different from the 8-month for part B so I decided to call Medicare to verify.
This morning, I reread the letter carefully and it did provide the correct information. Here is the pertinent part: "xxx has determined that the prescription drug coverage offered by our medical plans expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage...... you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
I totally agree that there ought to be an easier and less confusing way to distribute Medicare. Why there are different special enrollment periods for part B and D and why there are different rules with Cobra not considered 'creditable' coverage for part B but it could be considered creditable for part D.
In addition, no where that I can find the information on how far in advance that one has to apply for Medicare to ensure that the coverage starts at a certain date. I also don't know if one can apply ahead and specify the date for the coverage to take place.
3 months before you turn 65 is the "normal" enrollment.
3 months before you turn 65 is the "normal" enrollment.
My question is for the special enrollment for part B and D. The only 'answer' I got from the Medicare agent is that it takes 'about' a month from the application date for the coverage to take effect.
If there is a provision to specify the exact date for the coverage to take place, we would prefer to send in the application early. Right now, we have to take a guess to apply a month ahead to ensure continuous insurance coverage when our free Cobra insurance ends next March.
My question is for the special enrollment for part B and D. The only 'answer' I got from the Medicare agent is that it takes 'about' a month from the application date for the coverage to take effect.
If there is a provision to specify the exact date for the coverage to take place, we would prefer to send in the application early. Right now, we have to take a guess to apply a month ahead to ensure continuous insurance coverage when our free Cobra insurance ends next March.
For Part D, you fall into category 2 (You drop drug coverage) in the PDF link below. You specify when the COBRA drug coverage ends. You can start Part D then or you have the option of delaying the start of Part D up to 3 months but you specify the effective date.
Link to Part D SEP: Part D Special Enrollment Period
For Part B, you specify on the SEP request when you want it to become effective. You do need to submit it early enough to be processed.
Link to sample Part B SEP request: Part B Special Enrollment Period
In addition, no where that I can find the information on how far in advance that one has to apply for Medicare to ensure that the coverage starts at a certain date. I also don't know if one can apply ahead and specify the date for the coverage to take place.
Quote:
Originally Posted by BellaDL
My question is for the special enrollment for part B and D. The only 'answer' I got from the Medicare agent is that it takes 'about' a month from the application date for the coverage to take effect.
If there is a provision to specify the exact date for the coverage to take place, we would prefer to send in the application early. Right now, we have to take a guess to apply a month ahead to ensure continuous insurance coverage when our free Cobra insurance ends next March.
We've had reports on CD from people who do specify a specific date and their applications were not processed correctly - coverage beginning earlier than requested. Attempting to correct the error created more problems and confusion that it solved, including loss of Part B coverage entirely for a crucial month. Issue was eventually corrected - but not without a big and scary hassle.
My real life experience with Medicare Part B is I was discharged/retired from my job on Friday, September 3, 2009. On Monday, September 10th, I went to the SS office, enrolled in Part B effective October 1, 2009. Coverage began October 1, 2009 without any hitch whatsoever. I did not enroll in Part D because at the time I was covered under an employer retiree plan.
My sister retired June 30, 2015. She went to SS office (about five blocks from her house) around the end of May, applied for SS and enrolled in Part B to begin July 1 - which both did. She then saw an insurance broker in early June and bought a Medigap and Part D coverage - both of which became effective July 1, 2015.
So, a lot of lead time is not necessary and may complicate things.
My belief when dealing with the govt is to keep it simple. Applying four-five weeks before you want coverage to begin is adequate. Anything longer and you risk all manner of complications - like getting and being billed for coverage two months earlier than you want it. Trying to reverse that isn't easy.
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