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Medicare and Health Care


*This is a non-medical board. This site shall not be used to seek professional, medical or legal consultation.

Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age person with End-Stage Renal Disease (ESRD). There are many different parts to Medicare; with all of these options, it can be confusing.

This forum will allow members to share their experience with medicare and seek advice* on certain medicare-related situations.

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Beatle Boots  
#1 Posted : Friday, February 19, 2021 12:10:14 PM(UTC)
Beatle Boots

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Background: FERS retiree (turned 65 Nov 5, 2020) planing to keep FEHB (GEHA Std) & also enroll & maintain Medicare Part B coverage. I realize & accept that there is overlapping duplication & I will pay extra. Plan to delay receipt of SS retirement benefits to age 70.

Since I am duplicating health care coverage, I wanted to "TIME MY MEDICARE ENROLLMENT DATE TO SELECT THE LAST POSSIBLE MONTH OF THE INITIAL 7 MONTH ENROLLMENT PERIOD TO AVOID MEDICARES 10% PENALTY.

Here is Medicare's webpage that discusses rules regarding the 6-7 month Penalty Free Medicare Enrollment period for ones 65th birthday (to avoid penalty).

https://www.medicare.gov...a-part-b-sign-up-periods


After reading Medicare's description of the 6-7 month rules (to avoid penalty) I was a little confused. Medicare's example ONLY addresses someone applying EARLY (3 months prior to 65 Bday) not the LATEST POSSIBLE DATE (which would be 3 months AFTER 65 Bday).

I actually prefer the discussion of the 6-7 month rule provided by AARP on this webpage and the paragraph mentioned (understand AARP has no actual authority).

https://www.aarp.org/hea...rolling-in-medicare.html

"Your IEP lasts for seven months: The three months before your birthday month, your birthday month, and the three months after. So, say your birthday is June 15, you'll have from March 1 until September 30 to enroll."

Prior to enrolling for Medicare Part B on Feb 5, 2021, I called SS and spoke to a CS person. I explained what I was trying to do & he said the last time I could enroll penalty free would be anytime in February 2021 (given my Nov 5, 2020 bday). I wasn't confident in his technical knowledge during the call and he had to "speak to the boss" several times. He also refused to transfer me to the boss.

Fast Forward 1: On Feb 5, 2021 I enrolled online on SS' Medicare site for Part B. In the Remarks section. I thoroughly explained that I wanted to enroll PENALTY FREE in the third month following my 65th Bday, which I believed would result in an Effective Enrollment Date of Feb 2021.

Fast Forward 2. On Feb 19, 2021, I get a letter from SSA that says: "Your Medicare Part A starts Nov 2020 & Part B starts Dec 2020.

SS's letter stated my monthly rate is $148.50 (no penalty), but I believe that my Part B effective date should be Feb 2021 which would save me ($148.50 X 2 for months Dec 2020 & Jan 2021).

Fed Soup Request: Would appreciate if a knowledgeable Fed Soup source could opine as to whether or not Feb 2021 is the proper effective date for my Medicare application.

If Feb 2021 is the correct effective date for my Medicare coverage to begin, then I will contact SS and begin "fighting the fight". If I am incorrect, please advise and I will possibly say nothing and perhaps my experience will help others. I don't really want to get stuck paying the penalty which will eventually pay out if I live long enough.

Thanks in advance!





GoHuskers  
#2 Posted : Saturday, February 20, 2021 12:11:14 PM(UTC)

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Yes, the person at SSA really messed up your Part B enrollment. Here is a link to the table of contents for the SSA instructions provided to their employees regarding this. Sections .010 through .030 deal with initial and general enrollment periods and section .165.C explains what the effective date of the Part B coverage should be based on the month within the initial enrollment period in which the application was received. You do not have the option of selecting a month other than the month determined by those rules.

https://secure.ssa.gov/a.../poms.nsf/lnx/0600805000

Your initial enrollment period runs from August 2020 through February 2021. Since you filed the enrollment request in February, which was the last month of the enrollment period, the Part B should actually not be effective until May 2021.

You could have actually made the Part B effective date even later if you had waited until March to file. This is because in addition to the initial enrollment period there is also a general enrollment period that runs January through March of every year. Since your initial enrollment period overlapped with the general enrollment period, an enrollment in February is covered under the initial enrollment period rules. But an enrollment in March would be under the general enrollment period rules, with your Part B coverage not beginning until July of this year.

Something similar to your situation happened when my wife filed for Medicare. We waited until the month she was 65 for her to file which meant Part B should have been effective the following month. But SSA set the Part B date as age 65, meaning we were billed for an extra months premium. I had to go into the local office and file a request for reconsideration of the effective date established to move the effective date to the later month. I actually printed out the actual procedure from the POMS to show them what should have been done. When you contact the office to correct the situation you might want to quote the procedure above to them. I worked for SSA for over 36 years in one of the Payment Centers and the common opinion was that that the people in the local offices,while very dedicated and hard working in dealing with the public, were just not very well trained in some areas.
Beatle Boots  
#3 Posted : Saturday, February 20, 2021 1:19:55 PM(UTC)
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Originally Posted by: GoHuskers Go to Quoted Post


Something similar to your situation happened when my wife filed for Medicare. We waited until the month she was 65 for her to file which meant Part B should have been effective the following month. But SSA set the Part B date as age 65, meaning we were billed for an extra months premium. I had to go into the local office and file a request for reconsideration of the effective date established to move the effective date to the later month. I actually printed out the actual procedure from the POMS to show them what should have been done.


Thank you so Much GoHuskers! Wow wish I would have known all this before I started process. If it is ok, I have a follow-up question on to effectively appeal to SSA for "Request for Reconsideration of the Effective Date Established".

(1) Given Covid, how should I plan my appeal today?

(2) Is there any way to handle this by phone and bypass the random CS person who answers my call?

Note: Last time I called SS and got a random CS,to discuss my Enrollment Plans, he refused on 3 instances to let me talk to his boss. To me given the circumstances & dates of my application, I would think that a fairly low level employee could verify dates & SS summary level 7 months rules on SS webpage (no need to get into weeds of POMS), the Remarks on my application, & quickly conclude that SS used the wrong effective date. However, I have no idea the level of training and authority that the average SS employee has.

Thank you again!


GoHuskers  
#4 Posted : Saturday, February 20, 2021 2:36:52 PM(UTC)

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Requests for reconsideration have to be in writing and are handled by personnel in the Payment Centers, not in the local offices.

The first thing you should do is go download the form to request a reconsideration of the Part B entitlement date that was established.

https://www.ssa.gov/forms/ssa-561-u2.pdf

I've been retired for over 10 years and am not up-to-date on all the adjustments SSA has made due to COVID but do know that almost all employees are working remotely from home at the moment, which is why making contact with someone is more difficult. Check the award letter that you received. It should have instructions on what to do if you disagree with the decision. If it provides an address to use for the appeal, mail it there. If it doesn't and just says to call if you disagree, you'll have to do that. If you have a phone number for you local office, as opposed to the national 800# (not easy to find since SSA tries to direct the public to the 800#), I'd certainly try calling there first and asking them where to mail the appeal. My understanding is that many of the local offices have a small number of employees, mainly managers, working on site to handle things that must be done face to face but you would need an appointment to see them, you can't currently just walk into the office. I'm not sure this situation would qualify for a face to face meeting, but if they answer the phone they should at least be able to tell you where to send the appeal. Sorry I can't be of more help.
Beatle Boots  
#5 Posted : Saturday, February 20, 2021 4:31:34 PM(UTC)
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GoHuskers Thank you So Much!!!!

Read your response and everything checks out and makes sense.  I am mentally preparing my claim and am hoping you can give me your valuable professional opinion on my suggested CLAIM REMEDY (which month should SS use?).

As I mentioned, prior to submitting my application I contacted SS' 1-800 line and talked to a CS rep.  I may have a call date written to reference in my claim.  Also, I am unsure if the CS reps are required to maintain a call record by date & caller SSN and a summary of questions asked & advice provided? If so, this info may bolster & corroborate my claim.

During the CS call, I clearly outlined my intent on obtaining "The Latest Possible Medicare Enrollment Date that Would Ensure NO Penalty".  The CS clearly stated that I needed to submit my claim in Feb 2021.  The CS instructed me to include this info in the Remarks section of my claim.  So I did.  Specifically, I included the following verbatim remarks:

"I am a Federal Civil Service RETIREE who has elected to keep Federal Employee Health Insurance (FEHB) indefinitely.  I realize that I will pay for duplicated health insurance with Medicare & FEHB. I understand the Medicare will be the primary insurer once both polices are in effect.  I wish to enroll in Medicare A&B with a "Delayed Effective Date" as late as possible to avoid paying:  (i) Medicare late enrollment penalty & (ii) double Medicare & FEHB monthly premiums.  Specifically, I request my medicare app to be processes as follows:

(1) Sign Up Date - No earlier or later than 3 months after my 65th birthday (11/5/2020), & (2) Delayed Effective Coverage Start Date - No earlier or later than 3 months after 65 bday.

GoHusker Question:  Given the information above, Which Specific Month should I request SS use for my Medicare effective date (for coverage & monthly payment) to begin?

Note you mentioned some POMS exception rules that I was not aware of and I am wondering if you think I may be able to ask for & be awarded a later date based on POMS rules?

Thanks so much!
GoHuskers  
#6 Posted : Sunday, February 21, 2021 12:35:48 PM(UTC)

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If the application was actually filed this month (February) then the Part B should start effective May 2021.

I think that in order to make the Part B effective date July 2021 you would normally need to completely withdraw the application you have already filed and then file a new application in March. If you look in Section .080 of the POMS chapter I linked above it covers requesting the withdrawal of an application. As long as you request withdrawal within 2 months of when you filed the application it should be honored. But with it already being late February there are some timing issues that might result in an even bigger mess if you go that route as I doubt if SSA would get around to approving the withdrawal and notifying you of the approval before the end of March. As an alternative you might be able to avoid that hassle by just requesting equitable relief instead of just reconsideration (can still use the same form). Sections .170 through .210 of the POMS chapter cover this.

You might include a statement such as "As a federal retiree with FEHB coverage, my intent when filing for Part B was to have it start at the latest possible month to still avoid a 10% penalty increase. This intent was clearly indicated in the remarks I included on my application. Pursuant to a discussion with one of your 800# representatives, I filed my Part B enrollment request in February 2021, which is the last month of my initial enrollment period. Per SSA instructions in POMS HI 00805.165 the effective date of my Part B enrollment should be May 2021 based on that filing date. You have erroneously enrolled me in Part B effective December 2020. I have since learned that I could have waited until March of 2021 and filed for Part B in the last month of the 2021 general enrollment period. Then, the part B enrollment would be effective July 2021. At a minimum my Part B effective date should be changed to May 2021 based on the date I actually filed the application. In addition, I relied on incorrect advise provided by the SSA representative when deciding to file the application in February. If correct advise had been provided I would have waited until March to file. Therefore, I believe that the equitable relief provisions are applicable, and that you should change my Part B entitlement date to July 2021 to conform to my intentions."

What I'm wondering is if someone did make a record of your call to the 800# and SSA somehow used the date of that call as what is considered a protective filing date for the application. Did you perhaps make the call to the 800# last November? I ask because the Part B entitlement date established would only be correct if the application was filed in November. But even if that is when you called the 800# my recollection is that protective filing dates are not applicable for Medicare only claims, and in any case a protective filing date should not be used if it would result in an entitlement date that is contrary to the wishes of the claimant.
Beatle Boots  
#7 Posted : Thursday, March 4, 2021 8:59:24 AM(UTC)
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Originally Posted by: GoHuskers Go to Quoted Post
If the application was actually filed this month (February) then the Part B should start effective May 2021.

GoHuskers, Thanks for all your wonderful info. I have an update and subsequent question could really use your help with.

So I assembled all of my appeal documents (well documented claim thoroughly referenced with supporting docs and referenced to SSA applicable regs you mentioned and sent certified mail to local SSA office and just got of the phone with local SSA CSR to ensure Appeal was received, assigned to a reviewer, and get an estimated completion date (not to > 90 days per csr).

I briefly explained the background & basis of my claim to the SSA CSR lady.

She stated that my claim may be tossed out since I did not follow SSA policies/rules (unspecified) related to SSA's calculation of SSA Effective rules for all SSA related benefits. Here is a summary of what she said & some brief background.

65 Bday Nov 1955 (background)

Date I formally submitted Medicare A&B in SSA's system and signed certification. Feb 2021 (month 7)

SSA CSR noted that Feb 2021 was the Medicare Part B Application SSA calls this the application "RECEIPT DATE". (SSA does not use Receipt Date as the Effective Date for Medicare Application.)

The CSR was able to go into SSA's system and determine that in December 2020 I INITIALLY opened up SSA's Medicare application system and began inputting data into required fields, which I did to ensure that I started early and would be ready in month 7. She said that SSA uses the first date that an applicant opens up SSA automated enrollment system, for any SS related benefit, is the date SSA uses as the benefit APPLICATION EFFECTIVE DATE. Given this, the SSA CSR concluded that SSA was correct in establishing December 2020 as my Part B effective date.

I went back to the POMS policy you referred me to and searched on the terms "Date" "Effective Date", etc. I see nothing that supports the CSR's verbal statements.

Can you provide any assistance in this matter? Is the CSR correct? Are you aware of an obscured rule somewhere?

Frankly, if she is correct,this sort of blows my mind. Spent 35 years as an auditor who has audited many, many systems related to benefits, pay, etc. and have never seen any system that establishes as an effective date other than the application certification statement executed when the applicant electronically signs the document. Also, it would seem like SSA should have this info promanantly posted on some of the general public webpages posted above.

Thanks in advance for all your help!
Beatle Boots  
#8 Posted : Thursday, March 4, 2021 9:10:35 AM(UTC)
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GoHuskers, Forgot in last post to ask following question.

Had several phone questions with SSA CSR and in one call I discussed my intent for a discussion of how and when SSA calculates delayed enrollment in month 7 (this was the nationwide published SSA phone number not the local SSA office). I believe the CSR in this call provided substantial incorrect information so as part of my claim, I asked the SSA claim reviewer to review of the prior referenced SSA CSR phone log on this date to substantiate my claim.

After sending the claim I realized that SSA may not actually require CSRs to record contacts by SSN, date, and info asked and provided.

Question: Does SSA require recording of this detailed level of info and should it be available to the current SSA Claim Reviewer. Also, this person clearly did not advise to NOT pre-populate info into SSA's system to avoid early enrollment.
GoHuskers  
#9 Posted : Thursday, March 4, 2021 7:58:01 PM(UTC)

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I'm really not sure what sort of records are maintained by the representatives in a Teleservice Center, which is likely where the 800# person you talked to was located, as I never worked in one. I do know that those representatives have the capability to do simple inputs and send messages to the Field Offices and Payment Centers when necessary. Doing either would leave some sort of record in SSA's systems. But the record probably would not include a detailed summary of the conversation. The representative would be expected to be ready to take the next call ASAP, and would not normally take the time to write up a detailed summary of the call.

As I speculated in my last reply, the only way the Part B date they gave you would make any sort of sense is if SSA did have some record showing a contact in November (which would have to have been made by the person who took your call) but I could not tell you how much detail was included. In any case if the person who actually processed your claim incorrectly used the date of your call for your filing date, they should not have done so.
Citrine  
#10 Posted : Thursday, March 4, 2021 9:51:20 PM(UTC)
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I don't think geha standard and medicare B is excessive coverage. if you had a good supplement and a good part D plan, the cost might be close to the geha cost.


FEHB cost does not change with age. +++
teeeeej  
#11 Posted : Friday, March 5, 2021 11:44:51 AM(UTC)
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Originally Posted by: Citrine Go to Quoted Post
I don't think geha standard and medicare B is excessive coverage. if you had a good supplement and a good part D plan, the cost might be close to the geha cost.


FEHB cost does not change with age. +++


At some point, it would be a lot more. GEHA High has the Part B Reimbursement, I'd compare the cost of the 2 as GEHA High has cheaper prescriptions than GEHA Standard.
Beatle Boots  
#12 Posted : Friday, March 5, 2021 3:16:22 PM(UTC)
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Originally Posted by: GoHuskers Go to Quoted Post


As I speculated in my last reply, the only way the Part B date they gave you would make any sort of sense is if SSA did have some record showing a contact in November (which would have to have been made by the person who took your call) but I could not tell you how much detail was included. In any case if the person who actually processed your claim incorrectly used the date of your call for your filing date, they should not have done so.




GoHuskers: Thanks again for all your help!

Sorry for the sloppiness of my last post. Rereading it I now, I realize it was hastily prepared and not well prepared.
My intent is to keep this "Thread Open" until I get this matter resolved to assist others contemplating this approach.


Here is a quick summary of the key issues in pursuing a delayed Medicare Part B Enrollment application:

(1) 65th Bday Nov 2020 (Month 4 of 7)

(2) Dec 2020 (Month 5 of 7) opened up Medicare's Auto Enrollment System to figure out what info was needed & to pre-populate the required fields. I did not submit my application but instead I saved it for completion later. I did this so I could submit my application at the last possible time in Month 7 (Feb 2021) to avoid late Medicare's late enrollment penalty.

(TO ME, WHEN A DOCUMENT SITS IN STORAGE AWAITING FOR REVISION, SUBMISSION, CANCELLATION, ETC. THIS IS WHAT WE USED TO CALL A "DRAFT UNOFFICIAL DOCUMENT".)

(a) Dec 2020 I called Nationwide SSA Office (1-800) & spoke with CSR to ascertain how/when to complete my application at the last possible time to avoid Medicare late enrollment penalty. I was told I needed to SUBMIT application in Feb 2021 (month 7)

(3) Feb 2, 2021 (month 7), I formally electronically signed, certified, & submitted my Medicare application.


(4) I submitted an appeal of SSA's (Dec 2020, Month 5) effective date determination supported with: (i) applicable SSA rules & (ii) my signed, dated Feb 2, 2021 application.


(5) I called local SSA Office March 3, 2021 to confirm that SSA had received my appeal & they had. I briefly discussed the background of my appeal with the SSA CSR. The CSR said that the SSA uses the date the applicant first opens SSA's Medicare automated application system (Dec 2020, Month 5) to establish my Part B Effective Date. CSR also said that SSA uses this same method for determining the Effective Date for one's application for SS retirement benefits. She said SSA considered my formal signed Medicare application dated Feb 2, 2021 (Month 7)as the "Document Receipt Date" which is NOT used for my Part B effective date.

(a) The SSA CSR provided no regulation support for her statements.

I am now awaiting SSA's response to my written appeal. CSR advised that this may take up to 90 days.

To be continued.........
Beatle Boots  
#13 Posted : Tuesday, March 16, 2021 7:44:57 AM(UTC)
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3/16/21 OP Update.

Part 1 of 2 (To avoid character limitations)

Wow lots has happened to get to a verbal tentative resolution reached with SS management & IT Specialist to resolve my appeal. Too much to cover all of the details, but will hit major points to assist others that may go down this path in the future.

Summary of lessons learned that will help others avoid time consuming pitfalls.

(1) Know your 7 month timeline well and use the POMS reference provided by GoHuskers to compute your milestone dates. You may consider retracing my steps and asking for others on this or similar message boards. I am not sure I would call SSA to ask for help since this could be construed as date of first initial contact (see below). I would also not depend on using the extra month extension loophole at the end of the "General Period", briefly discussed by GoHuskers above, unless you thoroughly research it. I talked to several different SSA Mgt personnel, at different times, and they all advised that if I would have done this, given my circumstances, it would have triggered a late enrollment penalty. This loophole is tricky and risky. I did not do research to be confident enough, in using although I tried multiple times to get SSA management to let me use it due to the impact of multiple SSA errors in processing my enrollment.

(2) DO NOT (TIMES 10) open up the Medicare Auto Enrollment site UNTIL THE BEGINNING of the 7th month of your enrollment application occurs. The Medicare auto system and Medicare's policy use the First Date the System was Opened Up, or Initial SSA Phone Contact date, to determine the EFFECTIVE DATE of an Applicant's Intent to Apply. Understand, the majority of Medicare applicants (SS Supv estimated approx 99%) apply too late and incur a penalty or apply on time. Only a small faction of applicant's apply in the last month since they have other health insurance coverage. Key SSA POMS regulation references are listed below. I am sure politics has something to do with SSA use of "Protective Filing Date" (See POMS Terms & Definitions) for the "Most Advantageous Date for Individuals" to establish Medicare's Effective Application Date.

(3) Absolutely (100%) make sure when you open up the Medicare Application Enrollment System (on SSA website in 7th month) that you include in the COMMENTS SECTION a narrative similar to the narrative I wrote above. This narrative absolutely & solely "saved my rear" and allowed me to win & get my Medicare Part B Effective Enrollment date with May 2021 based upon February 2021 application submission. In my case, the SSA Supv stated that Medicare's system defaults to use the "Protective Filing Date". The SSA Supv advised that when the application includes written narrative comments, the reviewing SSA Tech is supposed to review those comments to ensure the "Effective Date" reflects the applicant's Effective Date intent. In my case this did not occur.

(Cont'd in next Part 2 of 2 below)
Beatle Boots  
#14 Posted : Tuesday, March 16, 2021 7:46:38 AM(UTC)
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3/16/21 OP Update.

Part 2 of 2 (To avoid character limitations)


SS Reg Support from POMS.

HI 00401.000 Provider and Related Definitions

http://policy.ssa.gov/poms.nsf/lnx/0600400000

HI 03010.020 Leads and Protective Filing
CITATIONS:

20 CFR 418.3230
Technicians can establish a subsidy application filing date based on a written or oral indication of intent to file, including an appointment for an initial claim made via the National 800 Number Network (N8NN) or a partially completed Internet Application for Extra Help with Medicare Prescription Drug Plan Costs (i1020). See HI 03010.015 for policy for determining the application filing date.

B. Establishing A Protective Filing
1. Criteria for establishing a protective filing
a. The claimant must be a proper applicant

A proper applicant is the claimant or his or her personal representative. See HI 03010.010B for the definition of “personal representative” for purposes of the Extra Help subsidy.

b. There must be an intent to file
Intent to file for the subsidy may be made orally or in writing. A partially completed i1020 meets the intent to file requirement. The start date for the partial i1020 is available using the I-Main menu by clicking on the “i1020 Internet Query” link.

c. Intent to file document must be filed with the Social Security Administration (SSA)
A beneficiary may establish a protective filing:

at an SSA office,

with an SSA employee on official duty at a place other than an SSA office, or


by partially completing an i1020 online via SSA’s online website (socialsecurity.gov).

--

Before I close this thread, I was told that SSA uses these same effective dates for SSA retirement application. I plan to wait till 70 to claim my monthly SS retirement (God Willing). Since I have not researched this topic yet, I myself may revisit this thread in the future. If someone has been down this path,and has a link to the calculation of effective dates for SS retirement, please feel free to post your links.

Thank you all especially GoHuskers!
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