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another Medicare question - wurm - 10-06-2021
I'm sure I'll end up calling Medicare about this (or the insurance companies), but in the meantime I'm wondering if anyone here has experienced this situation.
I signed up for Medicare Part A back a couple of years ago when I first had to, but declined Part B because I was still covered by my wife's employer's private health insurance. Well, her last day at work was last Friday, so we're covered only through the end of this month.
I applied for part B on Monday, but I understand it could take a couple of months for it to kick in. Meanwhile, apparently I need Part B before I can sign up with a Medicare Advantage plan (Yes, I'm leaning that way rather than Medigap plus Part D, but let's leave that conversation for another thread).
So what do people do whose circumstances are like mine, where I couldn't anticipate losing one coverage before needing to acquire new coverage?
Re: another Medicare question - rgG - 10-06-2021
You should probably check into getting COBRA coverage from your wife's employer, for any gap in coverage.
Not sure of her exact circumstances, but her HR person should be able to tell you if she is eligible for COBRA coverage which should also allow you to get coverage for up to 18 months.
Re: another Medicare question - graylocks - 10-06-2021
don’t get sick?
sorry. kidding. i did the sequence you did and if it’s any consolation it didn’t take a couple of months for me to get authorization that i had B. i think maybe one month. this was in March/April of last year so early pandemic.
And I chose an Advantage plan with Kaiser after checking them out for a year with my employer plan.
Re: another Medicare question - S. Pupp - 10-06-2021
I agree with the COBRA suggestion.
Alternatively, get a plan through the Obamacare marketplace to cover the period.
Re: another Medicare question - rgG - 10-06-2021
S. Pupp wrote:
I agree with the COBRA suggestion.
Alternatively, get a plan through the Obamacare marketplace to cover the period.
Since Wurm is already enrolled in Medicare, he isn’t eligible for HCA coverage.
Re: another Medicare question - DeusxMac - 10-06-2021
wurm wrote:
... I can sign up with a Medicare Advantage plan (Yes, I'm leaning that way rather than Medigap plus Part D, but let's leave that conversation for another thread).
You should initiate that thread.
Re: another Medicare question - GGD - 10-06-2021
I just went through this last month and spent a lot of time researching leading up to it.
The best people to answer questions about Medicare applications are Social Security 800-772-1213, they have more limited hours (7AM-7PM M-F). Call multiple times and ask the same questions a try to get the same answers three times in a row to be sure you're getting good info, In general I found them to be very competent.
The Medicare phone support (800-Medicare) is 24/7 coverage but they are more geared towards helping once you're enrolled, not with the enrollment process. And in many cases they would just read back text directly from the website and could not offer any interpretation of fine details of rules. Kind of like asking Siri for help.
If you both had Part A already then you're both over 65 and are applying for Part B under the "Special Enrollment Period". You're going to need two forms filled out CMS-40B and CMS-L564. The L564 form needs to be filled out by the employer to verify group health coverage dates.
https://www.cms.gov/medicare/cms-forms/cms-forms/downloads/cms40b-e.pdf
https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.PDF
The timing rules for Part B under Special Enrollment for us was that it's coverage starts the 1st of the month following the month that we applied which was a few months after employment ended and we had COBRA. We applied Sept 1st and Part B became effective as of Oct 1st.
But it looks like for you it might start Oct 1st because you're applying during the month that you still have employer coverage. See the directions on page 3 of CMS-40B for this language.
You can sign up for Part B anytime while you have a GHP
coverage based on current employment or during the 8
months after either the coverage ends or the employment
ends, whichever happens first. If you sign up while you have
GHP coverage based on current employment, or, during the
first full month that you no longer have this coverage, your
Part B coverage will begin the first day of the month you
sign up. You can also choose to have your coverage begin
with any of the following 3 months. If you sign up during
any of the remaining 7 months of your SEP, your Part B
coverage will begin the month after you sign up.
NOTE: COBRA coverage or a retiree health plan is not
considered group health plan coverage based on current
employment.
Re: another Medicare question - Dennis S - 10-06-2021
There’s an independent insurance agent here and people come from far and wide to get advice from her. There is probably an equivalent in your town.
Re: another Medicare question - wurm - 10-06-2021
But it looks like for you it might start Oct 1st because you're applying during the month that you still have employer coverage. See the directions on page 3 of CMS-40B for this language.
Thanks, GGD. Actually, She's not 65 yet, so she'll either do COBRA or ACH.
I applied for Part B on 10/1, so if it takes effect on 11/1, I should still be okay as we're covered by the company policy through 10/31.
Re: another Medicare question - GGD - 10-06-2021
wurm wrote:
Actually, She's not 65 yet, so she'll either do COBRA or ACH.
Try to find out the details of the COBRA plan, for us it seemed the only option was to continue the coverage unchanged from the employer coverage, in which case it meant both me and my wife needed to be covered. Because of that I spent a lot of time figuring out how to get my wife and I to start Part B at exactly the same time under different Medicare rules and end COBRA together. I turned 65 a few months after the employment ended, so I was going through the Initial Enrollment Period with a 7 month period centered on my birthday, but my wife was going through the Special Enrollment Period with an 8 month time limit from end of employment to apply.