Medicare Mistake: Big problem for Tucsonanby Denise Early on Jul. 06, 2012, under Health
Donna got her Medicare card in January, and it said her coverage would begin on April 1st, 2012. She enrolled in a Medicare Advantage plan, saw her doctors, and had her prescriptions filled under Part D. On July 5th, she received a letter from her Advantage plan saying Medicare informed them that Donna does not have Medicare coverage. What???
Donna got Social Security Disability back in March of 2010 and had to wait two years to get Medicare. That’s the rule. A person gets Medicare the 25th month after their Social Security Disability payments begin. Fortunately for Donna, she and her husband had health insurance, and they continued it until Donna got Medicare. As of April 1st, Donna dropped her health insurance and moved over to Medicare.
After getting the shocking letter from her Advantage plan, Donna called Medicare to ask what the heck was going on. She was told something along the lines of, “Oops, we made a mistake”.
According to Medicare, Donna’s start date should not have been April 1st, so they changed her record and canceled her Medicare Advantage plan. They told her she doesn’t get Medicare until March 2013 because they found in their records that they had made a mistake calculating when her disability status began. What???
Apparently, Donna has not had any health insurance since April 1st. Apparently, her medical and drug bills may not be covered for the last four months. And apparently, Medicare doesn’t give a hoot about Donna’s dilemma. Donna was told she can appeal this decision, but nobody could tell her how long that would take.
In fact, Donna has letters from Social Security from 2010, telling her she was awarded disability benefits as of March that year. In fact, the letters state that her disability was effective as of October 2009 and she would get back payments that were due to her from the period of October 2009 up to March 2010. In fact, she received those payments. Apparently, Medicare now wants that money back. What???
Donna is in shock – and she should be. She dropped her health insurance four months ago and cannot get it back. Given her health condition, she is probably uninsurable. Medicare made a mistake and Donna has a big problem – and Medicare does not care that their mistake (if there was a mistake) has left Donna at risk of running up huge medical bills if she gets sick or injured and has no health insurance. How can this be???
I told Donna to contact Congressman Ron Barber’s office to ask for help. There is someone on his staff who deals with Medicare and Social Security problems all the time. That person can help Donna – but I don’t know how quickly he can get her problem resolved. In the meantime, what does she do? She can apply for health insurance and see if she gets accepted and at what cost. But how long will it take to get her application processed if the insurance company needs to review her medical records? And of course, it is highly likely that she will be denied coverage due to her pre-existing condition.
This is an amazing and shocking story. I sure hope it gets resolved quickly.