81 Year Old Retiree Getting Jacked for Getting his Medicare

wehotex

Guru
1000 Post Club
2,362
Houston, Tex
I can honestly say that I've never had such a case and I don't know what to do for the guy. My member is very healthy and just decided to retire at the spry age of 81. He has Part A only since he's had employer coverage all of these years and is now trying to get his Part B. SS Gave him the form for his employer to complete, which was lost the first time by SS. Then, he received another form, but the most current employer has only employed and covered him since 2003. Another company (now DEFUNCT) employed and covered him during the 4 years of 1999-2003, 1999 being the member's 65 th birthday year. Current employer will ONLY vouch for the time since 2003. There is NO WAY that I can think of to get proof of the 4-year gap other than the Cert of Prior Health Plan coverage, which he can't find (of course). Since he's always been healthy, he doesn't remember which company insured the employees all of those years ago. We've already tried calling BXBS-Tx and Humana- no luck. I'm thinking that maybe SS will give him the PART B, but then charge him the 40% LEP surcharge for the rest of his life if he can't prove that he had coverage from 1999-2003. Has anyone else had this kind of experience with a client???
 
I can honestly say that I've never had such a case and I don't know what to do for the guy. My member is very healthy and just decided to retire at the spry age of 81. He has Part A only since he's had employer coverage all of these years and is now trying to get his Part B. SS Gave him the form for his employer to complete, which was lost the first time by SS. Then, he received another form, but the most current employer has only employed and covered him since 2003. Another company (now DEFUNCT) employed and covered him during the 4 years of 1999-2003, 1999 being the member's 65 th birthday year. Current employer will ONLY vouch for the time since 2003. There is NO WAY that I can think of to get proof of the 4-year gap other than the Cert of Prior Health Plan coverage, which he can't find (of course). Since he's always been healthy, he doesn't remember which company insured the employees all of those years ago. We've already tried calling BXBS-Tx and Humana- no luck. I'm thinking that maybe SS will give him the PART B, but then charge him the 40% LEP surcharge for the rest of his life if he can't prove that he had coverage from 1999-2003. Has anyone else had this kind of experience with a client???

Oh man, I went through this a couple of months ago. He needs to get a COC from the insurance company that covered him from 99 to 03. Because this is pre ACA, the company in 2004 may be able to determine who had the 03 coverage, then you keep going backwards. Its a pita
 
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