(i am using all caps because this is a very unusual web site in terms of how a person replies to a question or comment. I want my answer to stand out as different from your question.)
i am what is known as a ship counselor, a volunteer who helps people with medicare questions. The short version answer for you is that you need to appeal medicare's decision not to reverse your dropping of b (on grounds that you received bad advice/information from the government itself) and you need to go see a shine volunteer at your local massachusetts senior center (doesn't matter that you are not a senior) to help you with the appeal.
There are too many aspects of the long version of the answer to list here. You will need to know the following and many other things when you talk to shine:
1. What time period was involved here. All of this must have taken months, correct? You were not "all of a sudden" signed up for medicare; the effective date must have been two years after your ssdi eligibility date, correct (the shine person is going to need all this information)
2. What kind of masshealth insurance did you have that you were paying a $40 premium (if it was really commonwealth care, that might change the appeal logic)
3. You must have something in writing from medicare or ss concerning your "cancellation of part b." bring that to the senior center. (also i am assuming, because you thought you had masshealth, that you did not have a medicare supplement?)
4. Then the whole thing about what jen said about primary/secondary sounds wrong (since you don't have medicare b, then masshealth standard has nothing to be secondary to) but that's the least of your problems
also be careful, part a of medicare -- which you say is all you have now -- is for "admitted hospitalizations." that is not the same as "overnight hospitalizations." sometimes people are kept over night but only observed. Part a would not cover that.
Quote:
Originally Posted by joes21
i hear that this is a common insurance problem for newly disabled people in massachusetts.
short version:
I voluntarily cancelled medicare part b due to lack of information and being misinformed by masshealth. Now that i cancelled medicare part b, i have no insurance for anything besides overnight hospitalizations. I hope to get medicare part b back.
long version:
At the beginning of the year i was on a great masshealth insurance plan paying $40 premiums each month. Then, all of the sudden, i was automatically signed up for medicare parts a and b. Part b cost over $100 a month and covered only part of what masshealth covered. Masshealth informed me that my masshealth coverage would automatically be cancelled by the end of the month if i didn't cancel medicare part b. (i did my due diligence by calling masshealth to confirm that if i did cancel medicare part b, that i could remain on masshealth. They confirmed, but maybe shouldn't have or should have warned me...)
so, i cancelled medicare part b and called masshealth back to confirm that their computer system showed the cancellation of medicare part b. Masshealth then said that i would have to also cancel medicare part a to stay on masshealth. (part a only covers overnight hospitalizations.) so i called medicare and was informed for the very first time that i could not cancel medicare part a. The consequences for cancelling medicare part a are, 1. Having to pay back all social security benefits ever received, and 2. Social security payments will immediately be stopped. So, i'm stuck with medicare part a.
I called masshealth back to explain my situation: My masshealth insurance plan was going to be cancelled unless i cancelled medicare part a, and i could not cancel medicare part a. (and i need to see my doctors. My prescriptions are running out, i'm up for cdr, etc.) nice, yet incompetent, representatives at masshealth enrolled me in masshealth standard, a different masshealth plan than my previous one, and incorrectly said that that would cover my doctors visits.
I called masshealth back to figure out if my preferred doctors take masshealth standard, and was connected with an excellent long-time well-informed masshealth employee, we'll call her jen*. Before answering any of my questions, jen* said that she saw something concerning in my file. She said that because medicare part a is listed as my primary insurance and masshealth standard was listed as secondary insurance, masshealth standard would not cover any of the cost of my doctors visits. (this is the opposite of what i was previously told by masshealth. Jen* was more credible than the previous masshealth employees because she was able to explain things very well, whereas the other reps sounded confused and couldn't answer questions.) jen* continued, saying that federal insurance (medicare) is always listed as "primary" and state insurance (masshealth) is automatically and irreversibly listed as "secondary," so long as there is any kind of federal/medicare coverage. Jen* told me that she's worked for masshealth for a very long time and that she sees this happening to people over and over. Jen* said my best bet is to contact medicare and ask them to re-enroll me in medicare part b. She said that the pattern she's seen is when this happens, people are generally able to get back on medicare part b after going "round and round" a bit.
So then i called medicare and explained the situation. I am being told by medicare that the soonest i can be covered for doctors visits is in july of 2015. Open enrollment is in january, then there is a 6 month waiting period because i voluntarily cancelled. Per medicare, it does not matter if i was misinformed, not informed, etc.
who's had this problem before??? How did you fix it?
*i made up the name jen instead of using the masshealth rep's real name.
|