Need Advice - Quick

[jldavid47]

My wife and I had been assuming that her medical benefits (which I am on) were going to end at the end of December. We were informed just today that they will be ending at the end of NOVEMBER. I'm still having problems getting Social Security and Medicare to confirm that my benefits will start in January (It's been 6.5 weeks already).

Right now I'm completely uncovered (except for Medicare Part A) for the month of December. I now need Medicare Part B to start at the beginning of December instead of the beginning of January. I am going to call Social Security (yet again) tomorrow to see if anything can be done, but I am nervous that I will have no medical coverage for a month and that I have no real options other than Medicare since I am 66 years old. If it wasn't for COVID I could go to my local office and get everything straightened out but that doesn't seem possible at the moment.

Any suggestions?

 

[RockyMtn]

look into a short term insurance plan. Many of them out there.

 

[FrankiesGirl]

are you eligible to get COBRA coverage through your wife's policy? If so, it is my understanding that you don't have to apply for it right now, you can get it retroactively if you have a medical event in the next month. Contact her plan admin and get the COBRA details ASAP, and make them explain it to you and contact the insurance company as well to ask any details needed regarding applying and delaying application and how that would work.

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/cobra_qna

https://www.aetna.com/health-guide/cobra-coverage.html

You’ll have 60 days to enroll in COBRA — or another health plan — once your benefits end. But keep in mind that delaying enrollment won’t save you money. COBRA is always retroactive to the day after your previous coverage ends, and you’ll need to pay your premiums for that period too.

My understanding is if you can last until you get covered in January, you can avoid enrolling in COBRA and possibly save the (very high) premiums and just make sure to get your perscriptions and other routine stuff out of the way before the end of the month or make sure you can wait until Jan/Feb of next year.

BUT you can enroll in COBRA retroactively: like you need to see a doctor for urgent injury or something that would be crazy high cost without the (pretty high cost) COBRA on December 13 and can't delay for some reason until your other medical coverage kicks in. You immediately apply for the COBRA coverage and pay it up dating coverage to the end of the covered policy (end of November) and you're covered and can cancel it once you get the other coverage figured out. But also - once you CANCEL it, it's gone for good.

I am not an expert however so PLEASE do confirm how COBRA would work for you in your situation and do not trust random advice from the likes of me.

 

[jldavid47]

are you eligible to get COBRA coverage through your wife's policy? If so, it is my understanding that you don't have to apply for it right now, you can get it retroactively if you have a medical event in the next month. Contact her plan admin and get the COBRA details ASAP, and make them explain it to you and contact the insurance company as well to ask any details needed regarding applying and delaying application and how that would work.

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/cobra_qna

https://www.aetna.com/health-guide/cobra-coverage.html

My understanding is if you can last until you get covered in January, you can avoid enrolling in COBRA and possibly save the (very high) premiums and just make sure to get your perscriptions and other routine stuff out of the way before the end of the month or make sure you can wait until Jan/Feb of next year.

BUT you can enroll in COBRA retroactively: like you need to see a doctor for urgent injury or something that would be crazy high cost without the (pretty high cost) COBRA on December 13 and can't delay for some reason until your other medical coverage kicks in. You immediately apply for the COBRA coverage and pay it up dating coverage to the end of the covered policy (end of November) and you're covered and can cancel it once you get the other coverage figured out. But also - once you CANCEL it, it's gone for good.

I am not an expert however so PLEASE do confirm how COBRA would work for you in your situation and do not trust random advice from the likes of me.

Thanks. I believe I can, but I would need to talk with them. Right now, I know my wife cannot or she loses her retiree benefits she has which would be financially disastrous.


I have no prescriptions and I just had my annual physical. In a normal month I never have any medical expenses, but you never know.

 

[Buckeye]

When I have been between jobs, I would check the box that said I would be taking COBRA but then I didn't pay the bill when it came (if I hadn't already cancelled). If I had had a significant medical expense in the waiting period, I would have paid for a month or two of arrears COBRA (IF the charges were more than the expensive premiums).

 

[MissMolly]

So actually you are covered for 80% of most costs, the Part B (my understanding) mostly covers the other 20%

No, this is not correct. Part A covers hospitalizations. Part B covers doctors, test, immunizations, treatments outside of being an admitted patient, etc. Part B does not cover the 20% of Part A. They are separate types of coverage. This includes being in the hospital for observation but not being admitted. This scenario would be covered under Part B, not Part A. Part A only covers people who are formally admitted as patients.

 

[Time2]

No, this is not correct. Part A covers hospitalizations. Part B covers doctors, test, immunizations,

I think immunizations is to broad, as far as I can see it only covers the flu shot. once a year. I wish it covered Shingrix. My part D covers it, but I still pay $150 each.

 

[MissMolly]

I think immunizations is to broad, as far as I can see it only covers the flu shot. once a year. I wish it covered Shingrix. My part D covers it, but I still pay $150 each.

Well, yes a little broad, but covers a little more than just a flu shot:

Medicare Part B covers certain immunizations, including:
- a seasonal flu shot.
- a seasonal H1N1 (swine flu) vaccine.
- a pneumococcal (pneumonia) vaccine.
- a different pneumococcal vaccine, if given at least a year after the first shot.
- Hepatitis B shots for high-risk beneficiaries.

 

[Sunset]

No, this is not correct. Part A covers hospitalizations. Part B covers doctors, test, immunizations, treatments outside of being an admitted patient, etc. Part B does not cover the 20% of Part A. They are separate types of coverage. This includes being in the hospital for observation but not being admitted. This scenario would be covered under Part B, not Part A. Part A only covers people who are formally admitted as patients.

Thanks !!

I'm still learning about this.

I deleted my original message since it was so WRONG.... I don't want to mislead others.

 

[Chuckanut]

My limited experience with the SS system makes me think that no matter how early your apply for a benefit and how obvious the decision must be, they wait until 3-6 weeks before the actual start date to make a final decision. I applied for SS under my account months ago and still have not heard. I know I will get it, but I figure they are processing the people who waited until the very last week or two. Maybe, I'm wrong. It's just a hunch based upon my own N=1 observation.

 

[jldavid47]

Follow-up: I called Social Security the day after I originally posted and was first told that I could start Part B on 12/1 rather than 1/1 but then was told that there was some sort of "hold" on my account and the agent could not do it. After talking with Social Security again today, I was told that my Medicare Part B did, in fact, start of 12/1 so something was done after my call to allow that to happen. My Part G Supplement won't start until next month but that's not a big concern. So, I ultimately had a happy ending even though it was stressful for the past couple of weeks.

 

[Bamaman]

I was on Medicare with a Part G supplement this year. I decided last month to switch to Medicare Part F because it's got better durable medical goods coverage--no 20% co-pay on a $6800 insulin pump.

They allowed me to go ahead and sign up for Part F--effective 12/1/2020. I didn't have to wait until 1/1/2021 since I'm over 65.

 

[CRLLS]

I was on Medicare with a Part G supplement this year. I decided last month to switch to Medicare Part F because it's got better durable medical goods coverage--no 20% co-pay on a $6800 insulin pump.

They allowed me to go ahead and sign up for Part F--effective 12/1/2020. I didn't have to wait until 1/1/2021 since I'm over 65.

Am I correct that you mean "Plan G" and "Plan F"? From everything I have read, and it is a lot, I was under the impression that the only difference between them is the Medicare deductible coverage. I do know the various "plans" are Medicare minimums and some companies provide benefits in excess of the minimums. Is this the case with yours? I am curious as we changed last year from Plan F HD from one provider to Plan G from another.