Medicare for disabled - filing pains

[chrisaukcam]

Sharing this experience for anyone else is going down or is thinking of going down this same road.

So back in 2005 my wife was found to be disabled and started getting SSI. She also was eligible for medicare. But she didn't want it - so we kept her on my companies plan.

So now I am going to retire in 2019. We want to start medicare in 2019 for her so that we only have to worry about getting healthcare for me.

Well we now have to provide data to prove that she was covered from 2005 to now or we face fines. I had no idea. My way of thinking is that we saved the government thousands and thousands of dollars by sticking with private insurance. Instead we face a penalty.

Anyway we are now scrambling to contact the HR departments of the companies that I worked for during this period of time so get it documented that we were insured.

Oh and this is the 3rd visit by my wife to medicare. 1st visit - we need a letter from your employer showing you had insurance. 2nd visit - We provide the letter, "well the 1st person was wrong - it has to be this form." 3rd visit - Oh this employer only goes back 3 years. We need everything back to 2005... God only knows what they will also need on the 4th visit...

We feel like Charlie Brown and medicare is Lucy pulling the football away! Every time we give them what they want, they add on to the requirements.

Anyway, I wanted to share this for anyone else that is in this situation. If we had to do this all over again we would have just gotten medicare from the get go. One of the employers has moved their HR to the Philippines. My wife spent 3 hours alternately on hold and being transferred from person to person today.

This is ongoing and is anything but easy.

 

[Bamaman]

My wife was deemed disabled by Social Security after a two year fight with Georgia civil service workers administering the disability process and an appeal to an administrative law judge. I believe her Medicare was effective 2 years from when she was deemed disabled--retroactive. She had been piling up substantial charges for medical treatments on my MegaCompany insurance all that time. She has been using MegaCorp's excellent Medicare supplement since 2003--with me paying for it. I joined her on MegaCorp's Medicare supplement when I was eligible in 2015.

I understand that individuals that become eligible for Medicare (in most cases) and don't enroll will face a 10% increase yearly whenever they do enroll. I don't know if this is the same in your wife's situation. Maybe Medicare's trying to save you the penalty by demanding all the documentation that she was insured.

 

[Another Reader]

Sharing this experience for anyone else is going down or is thinking of going down this same road.

So back in 2005 my wife was found to be disabled and started getting SSI. She also was eligible for medicare. But she didn't want it - so we kept her on my companies plan.

So now I am going to retire in 2019. We want to start medicare in 2019 for her so that we only have to worry about getting healthcare for me.

Well we now have to provide data to prove that she was covered from 2005 to now or we face fines. I had no idea. My way of thinking is that we saved the government thousands and thousands of dollars by sticking with private insurance. Instead we face a penalty.

Anyway we are now scrambling to contact the HR departments of the companies that I worked for during this period of time so get it documented that we were insured.

Oh and this is the 3rd visit by my wife to medicare. 1st visit - we need a letter from your employer showing you had insurance. 2nd visit - We provide the letter, "well the 1st person was wrong - it has to be this form." 3rd visit - Oh this employer only goes back 3 years. We need everything back to 2005... God only knows what they will also need on the 4th visit...

We feel like Charlie Brown and medicare is Lucy pulling the football away! Every time we give them what they want, they add on to the requirements.

Anyway, I wanted to share this for anyone else that is in this situation. If we had to do this all over again we would have just gotten medicare from the get go. One of the employers has moved their HR to the Philippines. My wife spent 3 hours alternately on hold and being transferred from person to person today.

This is ongoing and is anything but easy.

Every year your employer should have sent you a letter that stated your wife had "creditable coverage." You should have kept those letters, although you probably did not know that at the time. If those letters are in your files, they should suffice. If not, that's what your wife should be asking to get - a copy of the "creditable coverage" letter for each year.

ETA: Here are the guidance notices from CMS. https://www.cms.gov/Medicare/Prescr...Creditable-Coverage-Guidance-and-Notices.html

 

[MRG]

Thank you for sharing. I had no idea.

DW was put on SSDI around 2002, she lost out on several years of back pay but oh well. Her one doctor really made a big deal about her getting on Medicare and that's why she signed up.

She was still on my insurance through Megacorp and I don't think she used Medicare until my retirement. I'm sure glad we didn't have the issue you're having. Good luck..

 

[MBSC]

Every year your employer should have sent you a letter that stated your wife had "creditable coverage." You should have kept those letters, although you probably did not know that at the time. If those letters are in your files, they should suffice. If not, that's what your wife should be asking to get - a copy of the "creditable coverage" letter for each year.

ETA: Here are the guidance notices from CMS. https://www.cms.gov/Medicare/Prescr...Creditable-Coverage-Guidance-and-Notices.html

The annual notice is to avoid Part D late enrollment penalties. There is no annual notice of creditable coverage for Part B. Hover over the link and you will see it directs you to the "Prescription Drug Coverage" section on CMS.gov.

CMS Form L564 is used to prove continuous group coverage for Part B:
https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf

 

[Another Reader]

The annual notice is to avoid Part D late enrollment penalties. There is no annual notice of creditable coverage for Part B. Hover over the link and you will see it directs you to the "Prescription Drug Coverage" section on CMS.gov.

CMS Form L564 is used to prove continuous group coverage for Part B:
https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS-L564E.pdf

Hmm...All the letters I got said to save in my records to demonstrate "creditable coverage" for Medicare. No mention of part D. I was going to toss them now that I am on Medicare but decided to hold on to them for another year in case there was a hiccup somewhere.

That's going to be a pain in the neck for most people. What HR department wants to go back a decade to find records for the spouse of an ex-employee?

 

[SumDay]

Hmm...All the letters I got said to save in my records to demonstrate "creditable coverage" for Medicare. No mention of part D. I was going to toss them now that I am on Medicare but decided to hold on to them for another year in case there was a hiccup somewhere.

That's going to be a pain in the neck for most people. What HR department wants to go back a decade to find records for the spouse of an ex-employee?

Grasping for straws here, but would insurance company Explanation of Benefits (EOBs) suffice? Did you keep these records for these years? I have found insurance companies keep better records than past employers do, although my quest was for a different reason.

 

[Another Reader]

What do the Medicare folks do if your previous employer is no longer in business and the records are not accessible? There must be some kind of acceptable substitute.