O.T. I cannot get my Medicare B

[george wilson]

I was laid off from Williamsburg along with 140 others in January 21009. As part of my severance package,I was allowed to keep my health care till July 31,2009,if I paid an $800.00 fee up front.

I have been told by the government that I was entitled to special enrollment due to my circumstances. Now,they have told me that because I had signed up for a Cobra health care plan,which is not a group plan,I have to wait till January to sign up,and Medicare part B will not kick in till NEXT July. Without B I cannot get D,the prescription plan. I did not know this about Cobra. No one told me about this snag. When I was fully employed,I had a group care program,and didn't know this was different as Williamsburg was subsidizing it just as if I was still employed.

This means I have to pay full price every month to continue Cobra for 1 full year at $467.23 per month.

I didn't realize this was the case till yesterday,and now I'm stuck. Does anyone know how to get around this word game that Medicare is playing with me? I paid into these benefits for 47 years,and now they deny me them.

[Frank Drew]

George,

Although I work in health care, I don't know nearly enough about the ins and outs of Medicare to give you any useful advice. I feel your pain, though; paying those high premiums out of pocket, especially when self-employed, out of work or between jobs, can be next to impossible.

I think your former employer's HR office should have done better by the people it was letting go; it's very difficult for a "civilian" to navigate the maze of regulations involving COBRA/Medicare/etc. on their own without some guidance.

Best of luck in the coming months, George; stay healthy!

[george wilson]

I think so too,Frank. This is just a silly word game the government is playing. I also might say that if we get nationalized health care,everyone is going to be put through telephone purgatory like I've been trying to get things straightened out.

Please,I do not want to hijack my own thread with a discussion of national health care. If anyone would like to discuss that,please start another thread.

[Mike Henderson]

I'm no Medicare expert but if you're 65, George, you should be able to get Medicare, no matter what other insurance you have. Medicare may be secondary rather than primary, however. If you're not 65, I have no clue. I don't have an idea what it takes to get Medicare coverage before you're 65.

I had a similar problem. Layoff before 65, carried COBRA, but when it ran out, I had to take a HIPA policy at over $800/month. I was really glad to see my 65th birthday come.

You specifically mention Part B. Do you have Part A coverage and just can't get Part B?

Mike

[Nathan Talbert]

I'm sorry to hear that. Just out of curiousity. Is Colonial Williamsburg closing all of the shops? I live in Virginia Beach and I absolutely love going to Colonial Williamsburg. I could spend hours talking to their cabinet makers. Best of luck to you and the other employees who were laid off.

[David Keller NC]

"This means I have to pay full price every month to continue Cobra for 1 full year at $467.23 per month."

Actually, George - you don't. Generally speaking, maintaining benefits through a COBRA plan will be far more expensive than purchasing private insurance through a non-profit like Blue-Cross/Blue-Shield, though that varies from state to state.

I went through this same thing, and the COBRA payment I was asked to make was about $500 per month. I got equivalent BCBS coverage for about $170 a month. That price will vary considerably depending on your age and health condition, but it's still usually cheaper than COBRA.

[george wilson]

I am 68. Cobra I have is Anthem/Blue Cross Blue Shield. And yes,I do have part A which is hospitalization. If I have to continue to pay for other insurance,I can't see that I need the part A,though.

This is pure crap. The government is playing word games with me. What difference does it make to them if I had a group plan,or Cobra? Fact is,the Cobra that Williamsburg subsidized as part of my 39 year severance package expires July 31. Then,I can keep it,but at full cost.

[george wilson]

No,they are not closing all the shops,but staffing was reduced in Historic Trades by 140,so visitors will see less activity. They closed the Harness shop,and combined the Gunsmith and Foundry.

I didn't mind being laid off,as I am collecting full retirement,but many not of retirement age were really hurt. I was the senior Master Craftsman in the dept.,with 39 years service. Wasn't going to die on the job anyway.

[David G Baker]

George,
I have found that what you get from Medicare varies from person to person depending on the people you talk to. Many of the folks that interface with the public do not have the knowledge or experience to deal with special cases. If you feel that you are really do qualify for Medicare you may want to consult with an attorney that specializes in that area.
I spent 45 minutes in a Social Security office and listened to the denials that were given to several people that were applying for benefits and was amazed at some of the answers the applicants were given.
Don't give up too easily and get educated.

[Mike Henderson]

I am 68. Cobra I have is Anthem/Blue Cross Blue Shield. And yes,I do have part A which is hospitalization. If I have to continue to pay for other insurance,I can't see that I need the part A,though.

This is pure crap. The government is playing word games with me. What difference does it make to them if I had a group plan,or Cobra? Fact is,the Cobra that Williamsburg subsidized as part of my 39 year severance package expires July 31. Then,I can keep it,but at full cost.
If you're over 65, you can have other insurance and still get Medicare Parts A, B and D. If you're working, Medicare is secondary and your work insurance is primary.

But if you're carrying COBRA, Medicare is primary and your COBRA insurance is secondary. But if you're on Medicare, you really don't want to carry COBRA - you don't need it - it's just wasted money.

I do remember that if you did not take Part B when you became Medicare eligible there's a waiting period - meaning: when you turned 65, you should have signed up for Medicare. At that time, if you refused Part B, there will be a waiting time later to get it. The reason is to keep people from refusing Part B and only taking it when they get sick. (at least, that's my memory from when I read the rules)

If you're being denied, I'd do like David B suggest and seek some help, maybe from a lawyer.

Disclaimer: I am not an Medicare expert. I did do some research on it when I was close to being eligible.

Mike

[Phil Thien]

If you're being denied, I'd do like David B suggest and seek some help, maybe from a lawyer.

I'm going to third that.

Another alternative is calling either your local TV station or newspaper that has a consumer affairs advocate. Sometimes getting a call from a TV station (and knowing some negative publicity may be on the way) is all it takes to get someone at one of these agencies to make it right.

[Bonnie Campbell]

Or you can try contacting your congress person and ask for their help. That's what they are there for. That was the route I took when my ex had Medicare problems. The person actually helped (shocking, I know).

[Gene Howe]

Or you can try contacting your congress person and ask for their help. That's what they are there for. That was the route I took when my ex had Medicare problems. The person actually helped (shocking, I know).

Bonnie's right. Call 'em.

[Butch Edwards]

it's easy to see, from the responses, that the Medicare/Gov't Healthcare is like anything else the Gov't handles...messed up. I've seen enough just at the VA to speak from experience... too much red tape. too many policies, that at times, seem to negate one another. I hope you finally get things straightened out,George... and if nothing else, this should make people aware of what questions to ask BEFORE getting hammered. we are told at the VA, that's it's OUR responsibility to find out ALL information regarding our retirement( which I'll receive in 3 years)..and that includes all benefits accompaning that retirement. they aren't gonna tell you anything, unless you ask...at least not here.

[Mike Henderson]

it's easy to see, from the responses, that the Medicare/Gov't Healthcare is like anything else the Gov't handles...messed up. I've seen enough just at the VA to speak from experience... too much red tape. too many policies, that at times, seem to negate one another. I hope you finally get things straightened out,George... and if nothing else, this should make people aware of what questions to ask BEFORE getting hammered. we are told at the VA, that's it's OUR responsibility to find out ALL information regarding our retirement( which I'll receive in 3 years)..and that includes all benefits accompaning that retirement. they aren't gonna tell you anything, unless you ask...at least not here.
If you think Medicare is messed up, you should try working with a private insurance company (like Blue Cross) in a similar situation. At least George has some avenues he can pursue with Medicare.

Mike

[Butch Edwards]

If you think Medicare is messed up, you should try working with a private insurance company (like Blue Cross) in a similar situation. At least George has some avenues he can pursue with Medicare.

Mike

no doubt, and that's just giving ammunition to the Nationalized Healthcare proponents....the worse thiungs get for people dealing with healthcare issues,the more likely and easier it'll be to institute nationalized healthcare....

[Jeffrey Makiel]

If you think Medicare is messed up, you should try working with a private insurance company (like Blue Cross) in a similar situation. At least George has some avenues he can pursue with Medicare.

Mike

My Mom (at age 82) has Medicare parts A, B & D. My brothers (age 51) have individual policies by BlueCross/BlueShield. I'm the medical coordinator for them all. I will tell you this, Medicare is much, much better to deal with than the private offerings. No frivoulous delays, no repeated denials, no referrals, no pre-authorization, and all the Medicare physicians and hospitals seem to know the rules. Oh, and most providers accept Medicare more so than BlueCross/BlueShield. In fact, we keep getting letters from BlueCross/BlueShield notifying us of more and more hospitals in my area that are dropping out of their network.

Keep working at it, I think it's worth it. Once you're on it, you're on it for life. The costs are much lower and you can get secondary coverage (perhaps thru AARP) which will provide you with an overall medical plan that is very, very comprehensive.

Good luck,
-Jeff :)

[Frank Hagan]

There is a subsidy available for Cobra payments as part of the stimulus package:


Workers who have lost their jobs may qualify for a 65 percent subsidy for COBRA continuation premiums for themselves and their families for up to nine months.
Eligible workers will have to pay 35 percent of the premium to their former employers.
To qualify, a worker must have been involuntarily separated between Sept. 1, 2008, and Dec. 31, 2009. Workers who lost their jobs between Sept. 1, 2008, and enactment, but failed to initially elect COBRA because it was unaffordable, get an additional 60 days to elect COBRA and receive the subsidy.
This subsidy phases out for individuals whose modified adjusted gross income exceeds $125,000, or $250,000 for those filing joint returns. Taxpayers with modified adjusted gross income exceeding $145,000, or $290,000 for those filing joint returns, do not qualify for the subsidy.

From the IRS Website (http://www.irs.gov/newsroom/article/0,,id=204505,00.html)


I hope that applies to you.



The other option is private insurance. Check out the plan from AARP (https://www.aarphealthcare.com/products/medsup/screen.aspx?ReturnUrl=/products/medsup/default.aspx) or your local Blue Cross/Blue Shield (they are non-profit). Since you have hospitalization with Medicare A, you only need a basic plan.



For drugs, ask your doctor if generics are suitable, and then check at Walmart, Sam's Club or Costco for the non-insurance price. Many generics are priced at $3 and $4 for a month's supply from them. If you are on a drug that is very expensive, and there is no suitable generic, contact the company and see if you can get into their reduced cost or free drug program.