UNITED STATES—Dear Toni, my husband recently retired from his job and because I am over 65, I needed to sign up for Medicare. I had to go to the local Social Security with the Request for Employment Information signed my husband’s HR department to sign up for Medicare Part B. I asked if I needed to do anything else and I was told I was all set. I received my new Medicare card in the mail with both Medicare Part A and B dates a few weeks later.
It was not until I went to the doctor in March and had my claim denied when I discovered that the old company insurance is still listed as primary not Medicare.
Now my nightmare begins…because the insurance company (Blue Cross/Blue Shield) said that I had to call Medicare to update Medicare’s system. Medicare said it would take 10 days to update. What do I do…I have no coverage because the company insurance is still listed as primary and neither Medicare nor my Medicare Plan G will pay? Please advise what I need to do? Janie from Lake Charles, LA.
Janie: In the past few weeks, the Toni Says® Medicare hot line has been receiving questions such as yours from those past 65 and leaving employer group benefits that are having their Medicare claims denied. Medicare still has the employer group health plan, whether it is UHC, Cigna, Aetna, etc., as primary insurance which supersedes Medicare and the Medicare Supplement or Advantage plan applied for.
There is a process that those leaving employer group health plans whether you are the employee or the covered spouse and enrolling in Medicare should do to verify which is considered primary insurance. Also, you need to inform Medicare that Medicare should be primary, and you or your spouse are no longer covered on an employer group health plan.
The verification process to discover what is your primary Medicare insurance is below:
1) Visit https://www.mymedicare.gov/ and register for a MyMedicare.gov account.
2) View what is in your MyMedicare.gov account and verify that your Medicare information is correct. Knowing this information, you will be able to view what Medicare is viewing while you are discussing your Medicare issues such as what Medicare plan you are using, what Medicare Part D plan you are enrolled in, Medicare claims and other Medicare issues.
3) If you see that your employer group health plan is still primary after you have enrolled in you and/or your spouse’s Medicare Part B, then Medicare is requesting that one call the Medicare Benefits Recovery Center at 1-855-798-2627 and advise the agent who answers that you and/or your spouse are no longer enrolled in the employer group health plan. The change from group health insurance as primary insurance to Medicare is estimated to take 48 hours.
We are advising those on Medicare to open a www.mymedicare.gov account when enrolling in Medicare whether you are turning 65 with or without employer group health benefits. Medicare mails out the Medicare Summary Notice (MSN) every 90 days or one can view it faster via www.mymedicare.gov.
Please email the Toni Says® Medicare team at firstname.lastname@example.org or call 832-519-8664 regarding Medicare questions including Toni’s stress-free way to enroll in Medicare. 2022 Confused about Medicare Zoom webinar is Thursday February 10 at 4 p.m. Visit www.tonisays.com to sign up for Toni’s online webinar event.