Getting Medicare Part B Back: Has anyone done so successfully?

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.

I have heard of this happening in another state with another type of state program, telling them to cancel their Part B. The only thing that they could do was wait for the open enrollment to get reenrolled in Part B. In your case you are lucky in that is not as far off as his was; he found out in February and had to wait a year and half before they could reenroll. He did get it back though then.

I am so sorry that you were given this bad information about dropping part B and that others are being told this as well. Perhaps by sharing this, it will help prevent others for falling into the same situation. Hang in there meanwhile.

(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.

I'm not "lucky" my continuing disability review is coming up. I could lose my disability income over this and potentially become homeless.

(I know SSDI has their own doctors, but in my case without going into a bunch of details, that's unlikely to work for me. It's complicated.)

Joe, you might want to try contacting the state AG's office about this, as it sounds like what you were told may have been somewhat predatory. They have a whole division for disability issues. I know several of the people who work in that office, and they're responsive people. If they can't help you, they can point you toward someone who can.

Thank you very much for responding. I'm going to look for a Shine Office in Boston.

Answers to your questions:

Timeline
(Dates below are approximate - yet probably all correct. I have the exact information in my files if needed.)

May 2014 - I moved so my mail was getting forwarded.
July 2014 - All of the sudden my SSDI was reduced by over $100 and I was told that was due to Medicare Part B. I received a notification letter well after the fact.
July 2014 - I called MassHealth to see if I was still covered under their insurance plan. The answer was, "yes, but only until the end of the month unless Medicare Part B is cancelled." (MassHealth did NOT warn me of the Medicare Part A scenario described in the OP.)
July 2014 - I called Medicare and asked to cancel Medicare Part B. Medicare asked me if I had other insurance and I said, "yes, MassHealth." I sent a letter confirming my cancellation of Medicare Part B. (Medicare did NOT warn me about the Medicare Part A scenario.)
end of July 2014 - I called MassHealth to make sure they knew that I cancelled Medicare Part B, pursuant to my previous advice from MassHealth. (MassHealth said they would put a note in their system so I can keep my MassHealth coverage in case the computer system is updated late. Still no warnings about Medicare Part A.)
August 2014 - I called MassHealth to make sure that I was still enrolled in their insurance plan. MassHealth said that my MassHealth plan was cancelled because their system shows that I was enrolled in Medicare Part A.
August 2014 - I called Medicare to cancel Medicare Part A too. That's when Medicare informed me that the penalty for cancelling Medicare Part A is having to pay back all SSDI money ever received and having my disability payments stop immediately. This was news to me. IMO, this is not a logical question to ask or in any way obvious.
August 2014 - I made multiple phone calls to MassHealth to see if there was anything they could do for me. (Part of the reason for "multiple" calls is that MassHealth transfers you around a lot, and often times there is eventually a recorded message saying something like, "All agents are busy. Please try again later." Then it hangs up on you.)
September 2014 - Eventually a MassHealth representative put me on MassHealth Standard and told me that that would cover all of my doctors visits even though I was also on Medicare Part A. (Medicare Part A ONLY covers overnight hospitalizations*.)
September 2014 - Since the previous MassHealth rep sounded confused and couldn't answer questions, I doubted that rep's competence. So, I called MassHealth back to confirm that I really qualified for MassHealth Standard and that my doctor's visits would be covered. MassHealth confirmed that.
October 2014 - I contacted MassHealth about a different matter. That's when the MassHealth rep stopped me and said that she saw something concerning in my file. She then informed me that MassHealth Standard will NOT cover any of my doctor appointments regardless of what I was previously told. (There's more about this in the OP above.)

The MassHealth plan I was on was BMC Healthnet through Commonwealth Care through MassHealth. (I wish it were simpler. I didn't invent this.)

I never received anything from Medicare regarding my cancellation of Part B. However, my SSDI check increased back to the pre-Medicare rate. In other words, the Part B premium is no longer being deducted from my SSDI checks. Over the phone, Medicare confirmed my cancellation because I called them.

I appreciate your letting me know that what Jen said about secondary coverage sounds wrong. Does anyone know where I can get credible information about this? I put that part in bold in the below quotation.

*I also very much appreciate your informing me that only admitted hospitalizations may be covered by Medicare Part A.

JoeS

(Unfortunately I think this will all get lost somewhere on this web site but I hope you see it. I am trying to reply to your reply to me but the way this site works, I cannot see your reply so I am trying to remember what you said.)

As I feared (because you said you were paying for it), you were not previously (in 2013) on MassHealth but on RomneyCare, private insurance subsidized by the Massachusetts state government (in your case, your RomneyCare was from Boston Medical Center--BMC). That means you may not be able to argue that the government advised you to drop Part B (which is the easiest way to win an appeal).

But... because of all the problems the state of Massachusetts had in Nov 2013-March 2014 trying to convert from RomneyCare to Obamacare, you may still be able to use the bad-government-advice argument. The SHINE person is going to need to know how you were handled in the RomneyCare-Obamacare transition (some people kept their Commonwealth Care, some were actually put on MassHealth Medicaid and will likely always be on it, and some were just given MassHealth temporarily--if you were in one of the last two groups, you might be able to use the government argument--it all depends on who the person who told you to drop Part B worked for)

As for my comment on primary/secondary, my point was that it's academic and therefore the least of your problems. If someone is on MassHealth Standard, and their other insurance does not cover anything but admitted hospitalizations, then MassHealth would not be secondary to the other insurance in terms of paying for things other than admitted hospitalizations like a doctor's visit. It would be primary because there is no insurance for it to be secondary to. But -- like I said, it's academic -- I suspect the issue is that Massachusetts should never have put you on MassHealth Standard in the first place because you are on Medicare. Again, the SHINE person will need all this information and the other information in my first reply.

Also, depending on where you live in Boston, contact Lynch's office or Capuano's office or whomever your Congressperson is. They might be able to just cut through the Medicare red tape and do a "ReSet". All you want is some computer somewhere to pretend that the Part B insurance that started up in July has always been there despite the fact that you called and cancelled it. You cancelled it because someone (a Massachusetts state employee or an employee of Perot -- which runs the Commonwealth Care web site -- or an employee of Boston Medical Center) wrongly told you to. You will have to pay the $104.90 for the months it wasn't taken out of your check though (August to now?)

By the way, none of what you are describing seems to relate to the fact that you are in a disability category (other than of course that's what caused the cutover to Medicare in the first place). All of these problems and timeframes would apply to anyone who dropped Part B and now wants to get back on

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You sure we're given terrible advice to cancel Medicare part B. The only example of that making sense to do that I've heard of is for veterans who get their health care at the VA.

Some states (maybe all) will pay your part B premium for you, if your income is low enough. To get that, you apply at your state's income support office. It's considered a form of Medicaid.

The medicare part B coverage is a separate issue from a CDR and was referring to the WAITING time you have to reenroll in part b as being lucky, that it could be longer is what I meant; nothing having to do with a CDR as did not know about this. Perhaps as MedicareHelp mentions, an appeal is possible too to get it back sooner.

I do hope your CDR goes really well; I will keep you in my thoughts and prayers for this and that the insurance situation get resolved soon too so that you have better coverage soon. HAng in there. (((((JoeS21)))))

This sounds like a great idea. Do you know if they will cover any premiums retroactively? The state of Massachusetts is backed up, I think, by a year if not more for their insurance premiums applications. If I pay Medicare B's premium, I will have to float it on credit cards. I simply have no money.

Get your application in to income support ASAP. I just got a refund of over two hundred bucks for part B premiums that I paid, since app was accepted and it's determined that I'm eligible for state subsidy. Did take a long time to process app. MA tends to have the most generous social safety net, so they probably help at least as much as my state does. Good luck with it. It saves you over a thousand dollars a year. I'ld go right ahead and put it on a credit card, if I had no other source of the money (about $104.00/ month.) Getting the subsidy might be dependent on being enrolled in Part B.

Thank you Rose. I wouldn't make such a big deal out of it, but I'm coming VERY close to a bankruptcy. It will take some talent to avoid one at this point.

Sometimes, avoiding bankruptcy isn't your best option. Only you can decide that, but just remember that bankruptcy isn't the end of the world either. If you have many thousands of unsecured credit card debt and you are looking at SSDI as your only income, it's an option to consider. Sometimes a good non-profit consumer advice agency will even encourage you to file bankruptcy. (Especially if you don't have assets to protect.) And it doesn't mean that you'll never get a loan again as long as you live, either.

Thanks everyone for all the wonderful information.

Sadly, I still have another question: If I cannot come up with the $104 a month at all, is there any other way I could see doctors and specialists?

(I am in the process of calling all of the hospitals around here and so far have found nothing. They have been referring me to MassHealth which has been useless per this entire thread. After I'm finished calling hospitals, I will call the AG too.)

Until you get your Medicare Part B back, you might be in a kind of Limbo. But do call the AG office, and see what they tell you.

When you get Medicare Part B, you should look into "Medicare Advantage Plans." (Like through Humana, for instance.)

Check out info on this non-profit link: http://www.massresources.org/medicare-health-plans.html

Sometimes, when you are poor enough, you can be on both Medicare and Medicaid. But I don't know how that works in your state. But it's never going to be in your interest to drop Medicare Part B. But I guess you've just learned that.

So far every single public program that uses income guidelines has failed me. This is because I have to pay about $1000 a month in student loans. These payments cannot* be deferred, forbeared, postponed, or cancelled. None of the public agencies take those payments into consideration when figuring what your income and expenses are. They just ignore those payments like they don't exist. So basically every public agency (Medicare, Medicaid, MassHealth, etc.) thinks I'm $1000 better off every month than I truly am.

*It's worth repeating that they cannot be postponed no matter what. I have gone round and round about that.

Wow. You have to pay out ONE THOUSAND dollars on month on this debt. I know that student loans get treated different from consumer debt. But supposed you stopped forking over that grand a month. What exactly would happen. I understand the debt cannot be canceled. But I have a hard time thinking that, if you reduced your payments to free up income for medical expenditures, that there would be a darn thing the banks could do about it. I'ld really like to know more about this.

Joe, have you tried contacting Sen. Warren's office about this? I know she's done/is doing a lot of work on student loan issues, and someone from her staff might be able to help. I have a contact in her office--you can PM me if you're interested.