I was giving the instance that Medicare WILL NOT allow you to overlap drug coverage. DH did get a threatening email from Medicare 9-21-2021 about being sure to have a drug plan in place now before the initial enrollment period ends “if you don’t have creditable coverage…” Yes we do have creditable health and insurance coverage – but we also cannot ‘risk’ their ‘work around rule’ to screw us and therefore we took the safe enrollment way and paid out the extra almost $600 for the Medicare B to be secure for June. So with his telephone supplement drug plan application, the clerk was good with starting the drug coverage Oct 1 with our prior coverage ending Sept 30.
We have paid the price for being misinformed and jacked around - we have had to dog the local SSA office for 2 straight weeks now – the first part of last week was following their instructions with 2 drop offs of documents AND then this week what was supposed to be an appt but instead was a clerk bringing DH a form to sign at the car. Their one processor who is handling DH’s situation (he is in management based on his title) is the one now entering and checking things daily until the system has DH’s Medicare A and B be correct.
Once on the drug coverage enrollment processing – once they knew DH had Medicare A and/or B and his drug coverage ended Sept 30 (actually no coverage Oct 1 but Sept 30 was last day of coverage) they allowed (and via email today) approved his enrollment in the drug plan we selected. However I am going to have to see after all this SSA goofing around with DH’s Medicare A and B until the system ‘takes’ it with June 1, that we somehow don’t get ‘canceled’ on his supplement and his supplemental drug coverage. My former employer did download my BCBS end of coverage info Friday morning and confirmed that BCBS got it - I actually got a call from BCBS at 3:15 pm because one of the people at BCBS that I spoke with confirmed the system was showing the private coverage end date – their system has to take time to now ‘approve’ my supplement application. We then also put in DH’s supplemental application for same BCBS of AL C+ plan G after that (before they closed at 5 pm) - as we knew BCBS showed end of coverage. Again once we know SSA has Medicare A and B showing for DH for June 1, then we can reach out to BCBS and make sure his supplement is approved (and not rejected during the juggling around SSA has to do). It will take BCBS a few days to process - but all should be in place Oct 1 with all the checks I need to do to make sure nothing gets canceled.
@thumper1 - yes the lagging spouse enrollment doesn’t goof up the ‘special enrollment’ the spouse older than 65 can have with their Medicare B. It just is a problem with the overlap of the spouse’s initial enrollment period - spouse A and spouse B overlap initial enrollments. They have a rule that DH cannot have a ‘special’ enrollment during his initial enrollment period (that continues for 3 months after his BD month) - no matter about this specific circumstance. However they do have a rule if your BD is the first of the month you actual enrollment month is the month before (and again that sets up the initial enrollment period of the 3 months before and after).
ShawWife is about to turn 65 and we want to turn on Medicare A/B for her and sign up for Part D (we’ll use the plan I already have). They ask whether she is turning on SS also, because many people deduct their Medicare premium from their SS check.
I asked our very good financial advisor in what year she should request benefits from SS. Turns out that she only gets the spousal benefits (the virtue I guess of being an artist and while she is incredible successful and cash-flow positive, she never makes that much) when I start taking SS. So she can’t pay the premium from her SS benefits (until later). [I’m not taking SS either and my company pays for our medical insurance premiums].
So then he did an analysis on that and it is between 68 and 70, but if you assume that we make 5% on our invested money, we should wait until 70 (unless we think she will outlive me by quite a bit). The interactions of the two spouses requests really are complex.
The odds are pretty good that one of a healthy married couple will make it to 90+.
Suggest you run your numbers on OpenSocialSecurity; click on the additional tab. You can pick and choose retirement dates to see the PV of the mortality-adjusted cash flows. (Few financial advisors run that type of model.) Don’t agree that 5% is the correct discount rate.
I turn on Medicare A and B at 65 so Oct 1, and I did earn enough to draw SS on my own (a bit above what spousal would have been under DH who hasn’t started drawing yet).
I also am turning on SS for Oct 1. I had to pay for first quarter of Medicare - as they don’t turn on SS until after Oct 1 (payment for Oct is 2nd Wednesday in Nov) - it is how their ‘system’ is set up. Bill was due by Sept 25. SSA local office said once my Medicare is being taken out of my SS checks, the system will recognize an overpayment and make a refund.
Stuff you don’t know until you specifically ask. We continue to make ‘baby steps’ with DH’s Medicare B getting straightened out - will maybe know Tues or Wed. We will have to pay his Medicare B from June 2021 on and make the quarterly payments until he does draw SS.
SSA and Medicare computer system can work fine for easy/automatic stuff. Some of the other stuff, IDK. My lesson has been learned on the conflict I did sort of know about (no special enrollment during initial enrollment period) but their ‘fix’ is not fair to those who have initial enrollment period overlaps. We had to pay more specifically for overlapping insurance but would have been screwed on being able to sign up for the supplement on time and w/o a gap in insurance coverage.
Also a warning to those that have a group plan for stuff like say Delta Dental. A group eligible plan like say AARP’s Delta Dental will not cover the same and will cost more out of pocket for care/have more payments either disallowed or less on payment schedule. It turns out our dentist has his own ‘Dental Savings Plan’ - so once our COBRA dental runs out, we will pick up the annual plan through our dentist. They have a plan with healthy gums and a periodontal plan (individualized plan will be created). It will save us money while giving dentist the income stream.
Did you consider dropping your H from your employer’s insurance in June(?) when he turned 65 and was first eligibles for Medicare and have him go on Medicare back then (to avoid paying for two insurance policies)?
@bluebayou my employee plan was not expensive for the coverage. In addition to the Medicare B of $148.50 a month, the drug plan and the supplement would have added a lot more. Medicare does not have a ‘fair’ option for people having overlapping initial enrollment for the enrollees (spouses). SSA and Medicare should be fair to everyone. DH should have been able to enroll for Medicare B when he was over 65 and the credible coverage was ending. And their ‘fix’ to backdate to Oct 1 would have meant we would not have had supplement in place without a gap and maybe even further problems.
I imagine this scenario happens often enough for them to allow this situation to be treated ‘fairly’ and not their goofy ‘fix’ which does not give equal option to first spouse with the intitial enrollment period overlap.
I can only imagine how many individuals do not have the managerial sense to say “no I need to stay on the line and not have to call back”; or “no, there is not enough time for us to wait for the Medicare cards to show up” - or fall for all their other stunts to get you off the phone and not really do anything to help. To say that you will have an appointment and then someone comes out and has you sign a form and says “it will get fixed today” - and it really doesn’t – input is made and they have to wait for the system to generate something system wide, and then they have to go in and fix again. It is TERRIBLE when it is not a clear cut SSA/Medicare scenario. And you cannot find answers on line (although Medicare does have a ‘chat’ which can give a little help) or there is a system lag so what enrollee sees is days behind what is on their ‘system’.
Sorry, but this is not an issue. Medicare is fair to everyone; it is an individual policy, and there is nothing spousal about it. You sign up in the month that you turn 65, or not. Your choice, or your H’s. He chose not to.
The fact that you may have a generous employer plan, and that Medicare might cost him (you) more that your employee pre-tax contribution for dependents is not Medicare’s issue. It’s fair to everyone in that same (albeit increasing rare) situation.
(yes, some supplemental carriers may offer some sort of family discount if you both sign up for the same Supplement plan, but that is on them and your local state insurance commission, not Medicare.)
No @bluehayou Medicare is not fair to not allow DH to have a special enrollment period for when my coverage for our healthcare ends (because he still is in his initial enrollment period) when he is 65 already and a special enrollment would normally be offered when credible coverage for him ends after he is 65.
I am not talking about pre-tax or anything else.
DH had credible coverage after 65 through the insurance I had with my employer.
We sign up for our supplemental insurance plans and our D supplemental drug plans separately just like all those who are not under Federal or other employee health care benefits. We just have to pay for Medicare B for extra months because he is not allowed to sign up for Medicare B after he is 65 and when his credible coverage ends.
I don’t know the reasons why spouse A cannot have a special enrollment when he qualifies for a special enrollment (being 65 and his credible insurance coverage ends) – I suspect their computer system cannot handle as they have set it up to not have a special enrollment during initial enrollment time – they don’t care that it affects initial enrollment situation of H and W and then disallows us to have the special enrollment others have.
Unless you have a spousal situation when you both turn 65 with ‘overlapping’ Medicare initial enrollment periods – you have not walked in my shoes.
To state this more clearly EVERYONE over 65 is allowed to have a special enrollment period after their initial enrollment ends when they have credible coverage which is ending UNLESS it overlaps with Spouse turning 65 and having their initial enrollment period right at that time (overlapping some months).
As @thumper1 stated - her H had no problem with his special enrollment.
Clarify to say that my husband did not have a special enrollment. He applied for Medicare 90 days before he planned to retire. His coverage with his employer was still valid. But since he was 66, he elected to take Medicare.
Special enrollment period for Medicare starts after the initial enrollment period is up for each individual, it has nothing to do with your enrollment period.
@thumper1 your H enroll in Medicare A during initial enrollment period when he was 65 did he not? (that is free). If you have credible coverage you can have a special enrollment for Medicare B out of the initial enrollment period - that is called a special enrollment. So he showed proof of credible coverage and switched to Medicare B at 66. So you may be continuing your private insurance after you have Medicare B - which maybe is supplement or if it counts before Medicare B IDK - those rules don’t affect me. You (wife/spouse) Medicare A and B at 65 was fine because he was out of your initial enrollment window; he was a little older.
YES @Mabelsmom it does - it affects his Medicare B – we could not use a special election period in a timely manner after his initial enrollment because my credible coverage for us ended Sept 30 (as last day of coverage) and DH could have had enrollment with credible coverage starting Oct 1 – EXCEPT it overlapped with my initial enrollment period. He could only have Oct 1 for Medicare B by their ‘work around’ which was after the fact and then we would not have had our supplement be able to start on time (so a gap with the supplement).
If we had learned properly 3 months before his June 2021 enrollment - but we have been misinformed by so many people in SSA. A supervisor is having to play around with their system until it does what we need to have it do – which is penalizing us money for Medicare B before we needed it but it was the only way it could be in place.
Y’all don’t understand! (proper term is All Y’all don’t understand) He only could enroll with Medicare B starting June 2021 or after Oct by backdating. Then on top of all of that we were getting threatening email about having to pay more than drug plan if we were not enroll by the end of Sept - having to pay more for life. I don’t care if we extended his individual coverage with paying COBRA for him through my company – I cannot take the risk of SSA/Medicare continuing this nightmare.
To repeat myself — If the government rules are not common sense, IT DOESN’T MATTER! If it is not fair across the board but they act like they are fair - what they say is everyone has to follow the rules. I am not going to learn if indeed Medicare administration can correct these kind of rules because I am done with all the time and grief (and extra money) they have extracted from us.
Please don’t tell me I don’t understand . Your husband had an initial enrollment period, which included the 3 months after he turned 65. HE has a special enrollment period, because HE had credible coverage, but that cannot overlap with HIS initial period. Just because HIS credible coverage is due to having spousal medical insurance ,it has nothing to do with your enrollment period. His Special enrollment period
starts after HIS initial enrollment period has ended. This is stated in many Medicare publications.
Your quote from 6 days ago
“Medicare would not allow us to have Medicare B be signed up with special enrollment overlapping his initial enrollment.”
THIS was your mistake , maybe from not understanding or misinformation from people you spoke with.
My husband is younger than I am. I went on Medicare 5 years ago. He went on Medicare this year at age 66…but had credible coverage until the day his Medicare went into effect.
Did your husband apply for Medicare 90 days before he wanted it to begin? That’s an important component.
I’m really not sure what your Medicare enrollment date has to do with your husband’s. But if that is what SS is telling you, then, I guess listen to them.
“Your husband had an initial enrollment period, which included the 3 months after he turned 65. HE has a special enrollment period, because HE had credible coverage, but that cannot overlap with HIS initial period. Just because HIS credible coverage is due to having spousal medical insurance ,it has nothing to do with your enrollment period. His Special enrollment period
starts after HIS initial enrollment period has ended. This is stated in many Medicare publications.”
This is correct. It has nothing to do with SOS’s application.
The SEP is for those who do not enroll during the Initial Enrollment Period (IEP). By regs, even if one applies for the SEP during the Initial Enrollment Period, the IEP takes precedence, and the Service must process it as an IEP. Perhaps not “fair”, but those are the rules, and have been for many years.
(ask SS for the POMS which they should be following)
But we cannot enroll for special enrollment period until AFTER Oct 1 when we are eligible Oct 1 on his special enrollment.
we would have needed to work around. His special enrollment period starts Oct 1 but he cannot sign up for it to be effective for us to have supplement in place.
Yes we did have misinformation. And this is not a Medicare situation that should be in place. But it is what it is. We should be able to have a special enrollment with credible coverage ending. But Medicare cannot have it in place.
So maybe if this was you and you believed you understood all the rules and regs. It only matters on how they interpret and can implement their rules and regs.
I would have needed to retire later or paid more to keep his insurance in place. I don’t want to go through more of a nightmare. If some of you want to feel Medicare and SSA run things just great, that is your opinion.
Where does it say that the special enrollment cannot start on the first day after initial enrollment period ends if that is when credible coverage ends?
Medicare has very specific rules for the supplements and drug plans to follow. I want things to be simple and straight forward.
We were misinformed very early along and all along until after our Sept 2 submission. Then even the local office stalled as some of them didn’t know the options - we were told different things.
We should have bugged the local SSA office 3 months before his start of his initial Medicare enrollment period and then verified and verified. Then document who all we talked with and kept very close on it all.
I think a lot of people get misinformation from Medicare. That’s why I’ve suggested that people get advice from the free Medicare brokers. (Per SOS, that probably would not have worked in their special situation, but in many cases I think it could. They likely hear a lot of horror stories)
@Mabelsmom My H and I can have our opinions based on our experiences. We are smart people and good communicators. This is it. You are right and we are wrong. So be it. You also don’t have our situation.
There is a lot to understanding how SSA and Medicare work for various situations and for their employees to provide factual information for beneficiaries to be able to use the system in a timely manner and correctly.
Our overlapping initial enrollment dates affected us when I wanted to have my coverage end and me smoothly go onto Medicare A and B, and DH smoothly be able to start Medicare B on what should have been an open enrollment period for him. But SSA/Medicare cannot process anything advance like one day after the initial enrollment period ends. And that is what has goofed us up - not understanding their system limitations and how we could therefore not have our supplement be in place w/o a gap in our fuller insurance coverage.
If I were not me, I would not be trying to figure out this situation other than a head’s up on how to avoid – like checking with a Medicare broker.