UNITED STATES—Dear Toni, my husband recently retired from his job and because I’m 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 The Woodlands, TX.

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 who 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 simple 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 calls 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.

May’s Confused about Medicare Workshop:

  • Online Medicare Webinar Available-Wednesday, May 22 for those who cannot attend our local workshops in Houston, view our webinar online on May 22 at 4:00 p.m. CST, the Medicare webinar is available at https://attendee.gotowebinar.com/register/7179352831418282753

If you are still confused and would like to discuss your specific Medicare circumstances either email info@tonisays.com or call 832-519-8664 and the Toni Says® team can help you. Toni King, author of the Medicare Survival Guide® Advanced is giving a $5 discount on the Medicare Survival Guide® Advanced book and bundle packages as a Thank You for the Toni Says® newspaper article readers. Go to www.tonisays.com to purchase.