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Final Rule for Part B Enrollment Changes
- Thread starter kgmom219
- Start date
Truce
Expert
- 81
Got a call today.
67 y/o woman worked for a large employer until 12/31/22 and gave notice of retirement mid December. Figured she'd just use cobra for her and her 67/y/o year old spouse since they liked their coverage and were getting cobra subsidized heavily as part of a severance deal.
I gave her the news that she needed Part B ASAP (both already had Part A). She said she got her cobra letter after 1/1/23 so how could she have known?
Told her to call and tell her story to social security focusing on the timing of the letter and ask for retroactive Part B to 1/1 so she doesn't have a coverage gap.
Local SS office told her no problem for the 1/1 and she is bring the 40B and 564 to them tomorrow.
Would they have always done this retro for her? Or is it tied to the new 2023 "my employer gave me bad info" SEP? Or just random?
67 y/o woman worked for a large employer until 12/31/22 and gave notice of retirement mid December. Figured she'd just use cobra for her and her 67/y/o year old spouse since they liked their coverage and were getting cobra subsidized heavily as part of a severance deal.
I gave her the news that she needed Part B ASAP (both already had Part A). She said she got her cobra letter after 1/1/23 so how could she have known?
Told her to call and tell her story to social security focusing on the timing of the letter and ask for retroactive Part B to 1/1 so she doesn't have a coverage gap.
Local SS office told her no problem for the 1/1 and she is bring the 40B and 564 to them tomorrow.
Would they have always done this retro for her? Or is it tied to the new 2023 "my employer gave me bad info" SEP? Or just random?
- Thread starter
- #23
Deep breath. They are ok. You forgot about the COBRA window.
There's an 8 month window for COBRA so that she doesn't pay the LEP. She can ride out the COBRA 60 day window and save some money. Its really more of an issue on prescriptions.
Its not a coverage gap if they can get coverage if they fall and break their leg walking into the grocery store and wind up with a $100K surgery.
There's an 8 month window for COBRA so that she doesn't pay the LEP. She can ride out the COBRA 60 day window and save some money. Its really more of an issue on prescriptions.
Its not a coverage gap if they can get coverage if they fall and break their leg walking into the grocery store and wind up with a $100K surgery.
Truce
Expert
- 81
My concerns were the Medicare secondary rules since she is no longer an active employee. COBRA coverage is secondary to Medicare, and no Medicare B means paltry COBRA reimbursement for claims other than hospitalization and drugs. It's a giant gap in her coverage.
My question relates to the retroactive sep for loss of employer coverage. I figured she'd be stuck with 2/1 Part B since her paperwork will be submitted after 1/1. Was wondering if it's always been that routine to get a retro date (in fairness it's not done yet for her, but she sounded reassured by what the local office told her today).
My question relates to the retroactive sep for loss of employer coverage. I figured she'd be stuck with 2/1 Part B since her paperwork will be submitted after 1/1. Was wondering if it's always been that routine to get a retro date (in fairness it's not done yet for her, but she sounded reassured by what the local office told her today).
- Thread starter
- #25
