The Tucson senior whose Medicare record was incorrectly changed to “deceased” received good news yesterday.  He got a call from a Medicare representative to inform him that his record had been corrected.  I was very impressed that Medicare, a bureaucracy with over 40 million members, called this man to apologize for the problem and let him know it had been fixed.

I have a feeling this Tucson citizen got some special attention because Congresswoman Gabrielle Gifford’s office got involved in his case.  On top of that, the Medicare Administrator put one of his aides on the case after I requested help last week during a conference call.  I’m not sure where the credit for the fix lies, but I am impressed by the quick action and efforts of Dan Frey in Congresswoman Gifford’s office and Peter Ashkenaz at Medicare headquarters in Washington, DC.

The problem for this Tucson senior arose when his wife died two months ago.  Because his wife was a housewife throughout her life, her Medicare number was her husband’s number with the letter B after it.  It is not hard to imagine that Social Security could make a mistake with this number that appeared in both the wife’s and her husband’s record.  Social Security changed the husband’s record to “deceased” and this information went to Medicare.

When this man went to enroll in a new Medicare Advantage plan, he was “denied due to death” by the company.  That happened a month ago and we went round and round trying to figure out how and when his Medicare record would get fixed.  I’m happy to report that this man also was informed yesterday that he is enrolled in a new Medicare Advantage plan for January 1.

I recently wrote about a Tucson senior whose Social Security record was incorrectly changed to “deceased”.  This man has talked to Social Security on the phone, met with them in person at the local office, and been assured that his record has been corrected.  That was more than a month ago, but Medicare still has him as dead.

An aide from Gabrielle Gifford’s office talked to Social Security this week - but it’s Medicare that has the problem.

Wednesday, I was on a conference call with the Medicare Administrator who was talking to the press about the end-of-year deadline for Medicare beneficiaries to change their Part D and Medicare Advantage plans.  As a blogger focused Medicare I get invitations to Medicare administration conference calls with “the press”.

When it came time for questions, I decided I might as well ask the top guy at Medicare if he could fix the Tucson senior’s problem. Dr. Berwick, the boss at Medicare, asked for my phone number so he could follow up with me to see if this problem gets fixed, and one of his assistants asked me to get the details to him so he could get it fixed.

So we’ll see how long it takes to fix a Medicare problem when the top guy says “get it done!”.  I’ll report on the outcome.

I received the following email yesterday and I thought I would post the question and my response here.

“I am a female aged 75, widow. Since age 65, I have always had Plan J, AARP/United Health Care medigap/supplement insurance ($229 mo that also includes Part D Rx). A rep from United Health Care called me today to try to get me to change to a Medicare Advantage Plan 2.

If I am willing to pay more for a premium in order to have the best, highest coverage using in and out of network doctors and hospitals, including Part D…. shouldn’t I stay in my Plan J and Part D Rx with United Health Care and not change to a Medicare Advantage Plan? I have not had any serious illness for years.”

My response:

If you can afford your Plan J Medigap coverage, you should keep it.

The good thing about Medicare Advantage is that it offers seniors another choice for their Medicare coverage. Many people don’t want to or can’t afford to pay a $229 monthly premium, and they can take the “pay as you go” option of Medicare Advantage. You have chosen the “pay in advance” option of a Medicare supplement, and that is the best coverage if you get sick.

Many seniors who choose Medicare Advantage say they don’t want to pay for a Medigap plan because they are healthy. But if they get sick, they will wish they had a Medicare supplement/medigap plan.

While you might not want to move to Medicare Advantage, you might want to consider moving to another Medicare supplement. Your Plan J is an older Medigap plan and is no longer being offered because Medicare has changed, and some of the Plan J coverage (preventive care) is now part of Medicare. So you are paying additional premium for something that Medicare offers for free.

Your Plan J drug coverage is not the same as Part D and is, supposedly, not as good as Part D plans that have been available since 2006.  Because you are healthy, you can shop for a Plan F (think full coverage) Medigap plan.  Your premium would be lower, but you’d also have to sign up for a stand-alone Part D plan.  You would have to do this by the end of the month because you can only pick up a Part D plan until December 31st.  You might want to call 1-800-medicar to ask what your status is with the drug coverage in your Plan J.  Do you face a premium penalty if you get a stand-alone Part D?  The answer to that question might influence your decision on keeping or changing from your Plan J.

It’s curious that you received a call from United because Medicare has rules against “cold calls” to Medicare beneficiaries. You have to be careful when you search the internet or respond to post cards for information because you may be giving someone permission to send you emails or call you on the phone. If you get a similar phone call you should tell the person to take you off their list so they don’t call you again.