The SS is Jacking a Prospect Around... HELP!

[G.Gordon]

Prospect called in, age 75, on wife's insurance through Century Link since '91...

Wife gets notice she's to be laid off end of Oct/2011.

Prospect calls the Pittsburg, KS Social Security office 10/2011 to see what he needs to do.

He's told to call back six to eight weeks before benefits end. Benefits end August 31, 2012.

Prospect comes into office Last month to make insurance decisions thinking his Medicare B will be effective 8/1/12 per phone call to SS in July. Based on letter from SS, we enroll him into Advantra Freedom PPO for 9/1/12 effective.

Plan responds that Medicare is not allowing enrollment due to not being on part B yet... we think it might just take time... wrong.

He gets denied enrollment into B due to missing his chance back in Oct/2011 (eight months) due to being told "call back 6-8 weeks before benefits end".

Now he's being told that he can enroll Jan-March/2013 general for a July 2013 effective. Due to SS giving wrong advice, this guys might have a SS part B penalty for life and he's got to run around uninsured for almost a year.

HELP!! Who can we call? Names/numbers?

 

[Norwayguy]

Prospect called in, age 75, on wife's insurance through Century Link since '91...

Wife gets notice she's to be laid off end of Oct/2011.

Prospect calls the Pittsburg, KS Social Security office 10/2011 to see what he needs to do.

He's told to call back six to eight weeks before benefits end. Benefits end August 31, 2012.

Prospect comes into office Last month to make insurance decisions thinking his Medicare B will be effective 8/1/12 per phone call to SS in July. Based on letter from SS, we enroll him into Advantra Freedom PPO for 9/1/12 effective.

Plan responds that Medicare is not allowing enrollment due to not being on part B yet... we think it might just take time... wrong.

He gets denied enrollment into B due to missing his chance back in Oct/2011 (eight months) due to being told "call back 6-8 weeks before benefits end".

Now he's being told that he can enroll Jan-March/2013 general for a July 2013 effective. Due to SS giving wrong advice, this guys might have a SS part B penalty for life and he's got to run around uninsured for almost a year.

HELP!! Who can we call? Names/numbers?

Does he still have the letter? I would have him call his Congressman and Senators. Interesting no SEP for Government screw ups.

 

[G.Gordon]

The letter is just the one where it's written in the blanks that he's applying for an August 1 effective... not actually saying he's been enrolled. Based on that letter, 100% of the beneficiaries in the past got exactly what the letter said. New twist for me.

 

[yogooglethis]

Prospect called in, age 75, on wife's insurance through Century Link since '91...

Wife gets notice she's to be laid off end of Oct/2011.

Prospect calls the Pittsburg, KS Social Security office 10/2011 to see what he needs to do.

He's told to call back six to eight weeks before benefits end. Benefits end August 31, 2012.

Prospect comes into office Last month to make insurance decisions thinking his Medicare B will be effective 8/1/12 per phone call to SS in July. Based on letter from SS, we enroll him into Advantra Freedom PPO for 9/1/12 effective.

Plan responds that Medicare is not allowing enrollment due to not being on part B yet... we think it might just take time... wrong.

He gets denied enrollment into B due to missing his chance back in Oct/2011 (eight months) due to being told "call back 6-8 weeks before benefits end".

Now he's being told that he can enroll Jan-March/2013 general for a July 2013 effective. Due to SS giving wrong advice, this guys might have a SS part B penalty for life and he's got to run around uninsured for almost a year.

HELP!! Who can we call? Names/numbers?

Did she go to local SS office with with Form CMS-L54 signed by employer and form CMS-40B signed by her requesting a 9/1/12 special enrollment effective date for part B? This can't be done online or by phone.It can be mailed to local SS office but I strongly discourage my clients from doing it because it can get lost and cause long delays.As long as she did this and has copies of the forms tell her to go back to the local SS office tomorrow and ask to talk to a supervisor.If it was a mistake on their part and she has a paper trail they will correct it.

 

[G.Gordon]

The mistake on the SS part was telling him to wait too long, not processing the paperwork or getting it in a timely manner.

Read part B SEP in the 2012 Medicare/You book, it clearly says: "Eight month period that starts the first of the month following the month that work ended or benefits ended, which ever is first."

Her work ended 10/25/2011. The "Period of Time" started November 1, 2011 and ended the last day of June/2012. So when he called in to make a SS appointment mid July... he was two weeks out of his SEP.

 

[G.Gordon]

Good news today!! After filing for "reconsideration" and explaining the hardship that will be caused over the next 11 months due to following their advice, they took two weeks and gave a good answer.

He had a voice mail at home telling him that the local SS office accepted full responsibility for the error and his enrollment will go through. He is traveling right now so we will re-enroll into the MAPD of choice for an Oct 1, 2012 effective.

YEAH!