Anyone from the state of Ohio . What does this letter mean

[Fire]

This Individual retired from the state of Ohio . I didn’t even know he had state coverage . He was paying $280 for a med sup with no Part D coverage for 12 yrs . He wanted a mapd . What is the $505 state is asking him back for ? What is reimbursement of the $505 Part A for the month ? Makes no sense . If he worked for the state he had free part A . Ok I read up on it . If you started with the state before 1986 you paid no Medicare taxes . The state pays your part A premium . I wrote him a mapd . He has coverage . If we send in proof of coverage won’t they continue paying his part A ? He had an outside Humana med sup and they paid his Part A.

 

[TwoCents]

I think you're hurting the client by writing coverage outside the OPERS system. Also look at the following list. Did the client start any kind of assistance that is now paying his Part A? Or did he not pay Part A to CMS?

OPERS Health Care Program - OPERS and Medicare

www.opers.org

You are receiving reimbursement for yourself:

• If you disenroll or fail to pay your Medicare Part A premium to the Centers for Medicare and Medicaid Services.
• You disenroll from your medical plan through the OPERS Medicare Connector.
• If the premium amount changes or you no longer pay a premium. Please notify OPERS immediately by submitting the Notice of Award or other documentation from Social Security that states the new amount and date the new amount went into effect (other than a premium bill).

If you are receiving reimbursement for your spouse:

• If your spouse disenrolls or fails to pay their Medicare Part A premium to the Centers for Medicare and Medicaid Services.
• Your spouse disenrolls from their medical plan through the OPERS Medicare Connector and/or you disenroll from your medical plan through the OPERS Medicare Connector or opt out of receiving the Pre-Medicare HRA.
• If the premium amount changes or your spouse no longer pays a premium. Please notify OPERS immediately by submitting the Notice of Award or other documentation from Social Security that states the new amount and date the new amount went into effect (other than a premium bill).

 

[Millwood]

I'm thinking OPERS had no clue he has/had a Medicare Supplement, and thought he was only on OPERS.
You putting him on a MA or MAPD kicked him off OPERS (OPERS was notified)and now he is going to owe the part A premium.

 

[Truce]

The link says he got his job pre 1986 when employees did not pay payroll taxes into Medicare, so they have a part A premium, and the state is paying it rather than provide a parallel insurance program.

I would tell him to stay in his state plan. Their approved sales vendor very well might have sold him the med supp.