HELP! Medicare for my mom! Policy cancelled?

[Synnical]

My mother neglected to pay her premium on time (she was two months late - I pay most of her bills, but she's trying to stay independent) and the insurance company canceled her policy. Now, I'm told, we have to wait until November to get her health insurance again? She's a cancer patient - went thru some extreme chemo and radiation treatements four years ago, has never really recovered from that. She has lost her salivary glands and some nerves on her fingers.

Medicare part B, Part D? WTF?

Any assistance would be so greatly appreciated! She has her insurance thru AARP.

http://www.aarp.org/health/medicare/drug_coverage/medicare_part_d_special_enrollment_periods.html

I know we have Bush/Cheney to thank and bitch about this, but I'm pleading for guidance here.

Thanks so much to anyone who can help. My mom is going to be 74 on July 30th

-Cindy in Fort Lauderdale

[EFerrari]

1. These bastards.

If you want me to help you make calls on Monday, pm me.

[whistle]

2. Sorry, contact SS and Medicare asap, explain what happened and bring the payments

...current. But get a SS/Medicare agent involved, they will work with you to straighten this out

[Synnical]

6. Thank you - I didn't know there was such a thing as an agent!

:)

[whistle]

31. Perhaps they refer to themselves as representatives...

...try these numbers on Monday:

For Medicare - 1-800-633-4227

For Social Security - 1-800-772-1213

SS TTY number - 1-800-325-0778


Also, a person who was very helpful to me several months ago was a Ms. Hill at 1-800-842-0588 ext 6520

Good luck!

[frebrd]

3. K&R

[MichiganVote]

4. She should have a caseworker. Her diminished capacity should count.

Make appointment....prepare to struggle....raise hell....she wins.

[ISUGRADIA]

5. I'd call one of Senator Nelson or your Member of Congress'

office and see if a caseworker can look into this to see if it can be resolved.

[sandnsea]

7. Call both Senators and your Congressman

In cases like this, party doesn't matter and you never know who might come to your defense. I imagine Republicans are trying not to upset the remaining 28%. I don't know why they don't make allowances to let seniors catch up Medicare premiums. You also might call Senator Kennedy's office. If there's an exception somewhere in Medicare law, they'd know. So sorry. It's wonderful of you to take care of your mom this way though.

[Synnical]

8. Are you kidding me?

I have to contact CONGRESS to get this resolved??? Just to get my mom health insurance? Medicare paid for most of her cancer treatments, but now, she has very little coverage. This is more than an outrage, it's madness. She paid into that fund all her life!

I'm beyond disgust.

[Donnachaidh]

10. It's either calling reps or getting a lawyer

And the lawyer option will take longer and cost you more. Seriously, call your rep. We had a friend who was a quadroplegic that was turned down for SS disability - and he really needed help FAST. His Mom got their senator on it and it got put through immediately.

[petersjo02]

9. Medicare parts A, B, and D premiums

are automatically deducted from SS payments, so I'm assuming it is her supplemental policy through AARP that has been cancelled. In that case, Medicare or SS people won't be of much help. Have you contacted the AARP insurance carrier and explained the situation? That should be your first step. I also suggest you call your state's insurance commissioner's office--part of your state government. They can at least tell you what your options are, and maybe they can apply some pressure where it is needed. Contacting your senators/reps in Congress may or may not help, since this is a supplemental policy rather than Medicare, but it won't hurt to call their offices. You may finally need to contact an attorney. Often they'll give a free initial consultation to see if he/she can actually be of help to you and your mother. Good luck.

[Synnical]

12. Yes, it's the supplemental policy that she was forced to buy

Yes, we have contacted AARP, they say we have to wait until November. This is beyond bad news. My mom is not in good health. She's been hospitalized so many times. She doesn't take care of herself.

Thanks so much for your feedback. And welcome to DU!

-Cindy in Fort Lauderdale

[Quakerfriend]

11. Write a Letter of Medical Necessity

stating exactly why she needs uninterrupted coverage. You should include her age and medical conditions/problems. You can also document evidence of her mental status, if this would build the case. Ask her MD to sign it and send it in.

I used to write letters of med necessity for dialysis patients and then years later I encountered the same problem you have. My mother began to lose her mental faculties and let her coverage slip. I did this and, voila, she was reinstated. They refused, however, to cover prescriptions.

Good Luck with it, and best of everything to your mom.

[Synnical]

13. Thanks, and who should I address this letter to? n/t

[petersjo02]

14. I believe the medical necessity letter deals with people of

pre-Medicare age and relates to them becoming eligible for Medicare coverage before the usual age of 65 because of a disability (medical necessity). I don't think this will help much in your case, since your mom already has all Medicare coverage that would apply.

The November thing with AARP must be their annual open enrollment period. That doesn't help you much in the meantime. I hope you find at least some of my advice above helpful and that you can get this resolved. A friend of mine who worked for an insurance company for many years told me that the first thing a person with a complaint/problem should do is to call the state insurance commissioner. Get on the phone Monday and make lots of noise. I'll be interested to hear how things turn out for you. Best wishes. jp

[frogcycle]

15. I expect that is correct about the open enrollment

whoever you talked to may just be a clerk - at the insurance carrier probably

I'd raise hell with AARP themselves. You aren't trying to enroll anew; you are trying to undo the cancellation. Whatever the grace period is, and the reminder policy, it is inadequate for elderly people.

AARP should know better, and you may be able to shame them into making an exception and/or actually changing the rules. Their members should have a designated backup and that person should be contacted in case of issues. Tell them you know Michael Moore.

[claypool4prez]

16. story

tell her story to Democracy for America.

They're working on a Health Care for America Campaign and collecting horror stories

democracyforamerica.com/healthcare

[Synnical]

17. Okay, why can't I just get her another policy?

Thru another company for general health issues?

-Cindy

[LSK]

18. did you see Sicko?

Pre-existing conditions.

[Synnical]

19. No, I haven't seen Sicko (yet)

And I get the pre-existing conditions thing. But, what if she gets a cold or the flu or breaks her foot? That's not a pre-existing condition.

[LiberalHeart]

25. Contact your state insurance commission....

They may be able to tell you about medi-gap HMOs that will be holding open enrollment. Where I live there is an HMO with Medicare product -- and they have to take everyone who applies. Your insurance commission should be able to tell you if there are similar companies where you live.

[susanna]

21. A little off topic, but semi-relevant I bet...

Something interesting that happened to me twenty years ago in Michigan, and it has to do with automobile coverage (which is mandatory in this state). I had a car. I insured said car; the car died (needed a new engine) around the same time I lost my job. So, I let my auto insurance lapse. It wasn't being driven, and I had more pressing needs, right? Food, shelter, crap like that.

So when I have the money to set things aright (about two months later), I get the engine repaired. Then I go to re-instate my auto insurance, and am told I must purchase "high-risk" insurance for at least a year. "What?!" says me; I've had no accidents, I am a safe driver, the car sat unused during th lapse period, I have no points, yada yada yada...they said to me, with a straight face: "by letting your insurance lapse, regardless of the reason, your CREDIT is in question and we can and do assign risk based on credit history." Sweet, huh? Insurance companies are the biggest racket on this green earth. So says me.

I only posted this because you're looking for new coverage. Every single one of those companies TALK to each other. They know what history you bring to the table. I'm not trying to bring you down, but please, be prepared for arcane rules and general stupidity just about everywhere you turn when talking to these companies.

And I agree with earlier posters; contact your reps and explain the situation. They (unfortunately for us "little people") have the most pull.

Best of luck to you. I wish you didn't have to go through this. :-(

[grasswire]

20. part B should be deducted from her social security check

I don't know about part D. Maybe it is, too.

[napi21]

24. Not D is not. That's why I asked the OP what part. n/t

[napi21]

22. What part of medicare are you talking about?

A & B are deducted frin your SS check, so are you talking about part D?

[mcctatas]

23. The same thing happened to my mother in law...

we are in WI so she called Sen. Kohl and the situation was resolved within the week (retroactively to cover meds she paid for out of pocket and everything). Since Herb is the Chairman of the Committee on Aging, it would be worth giving his office a call anyway no matter where you are from, he really got it done quick for her...

[LiberalHeart]

26. Once you get this straightened out, have the payment automatically deducted at her bank.

That's what my mom does. There's no fear she'll miss a payment that way.

[Lasher]

27. Are we talking about Medicare Advantage (Part C)?

This type of plan was formerly known as Medicare+Choice. Part C is not a supplement to Parts A & B, but rather an alternative to them.

Part A covers hospital bills.

Part B covers doctor bills.

Part C provides the option to choose from a package of health care plans. If you enroll in a Part C plan, you essentially opt out of Parts A and B.

Part D covers prescription drugs.

[Princess Turandot]

28. A medicare beneficiary's 'payment' for Part C is also directly withheld..

from the monthly social check. I believe this story relates to a personal AARP contract for supplemental insurance to cover the A/B coinsurances, which was cancelled because her mother forgot to pay the bill.

[Lasher]

29. Those supplementals are also known as 'Medigap' policies

I think you might be right. I hope she confirms this one way or another. A problem well stated is a problem half solved.

Edit: If we're talking about termination of a Medigap policy at least we'll know Parts A, B, and D are probably intact.

[Tulum_Moon]

30. BUMP

CALL Michale Moore!!!!!!!!!!!!!1

He will help. I promise he will do something!

[Synnical]

32. Thanks everyone for your comments and suggestions

I'll start making calls and writing letters. What a scam, I'm disgusted and shocked.

-Cindy in Fort Lauderdale