A VERY important posting about ssdi and medicare health ins

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missie1227
Veteran Member


Date Joined Nov 2005
Total Posts : 751
   Posted 6/15/2006 10:55 AM (GMT -7)   
i had united health care ins for a long time. now that i got ssdi, and was  now available for medicare, I opted not to go into it medicare since i had united which was pretty good coverage 80 % of everything and scripts too. for $80 a month. so i cancelled medicare part a and b saying and thinking i could do this since i all ready had united health. now united health care calls me up and says if you were allowed to do medicare and didnt sign up for it, then we a re only going to cover you  for 20% now instead of 80 % like before.
i goofed up ....to all of you who have ssdi or are about to become approved for it and have waited out your 29 months and now qualify to be on medicare, YOU HAVE to sign up for it....CALL your health care provider if you have one now to see waht the regs are on this.
 
i am now going to be responsbile for 80% of the fees on all doc bills, and ct scans and scripts until i can get on the medicare next year as they already closed the enroll ment for this year now.
this means BARE bones doc appoitments for me, bare bones scripts, and no pt for the rst of this year.
i just shot myself in my own foot friends, dont let this happen to you!!!!
i have to now pay 80. month for united for  20% coverage and i lost medicare coverage until next year.
 
it is bad enough that many docs do not like taking on medicare patients if you can find one that will, which is WHY i didnt opt to take the medicare in the first place.
now i am forced to do this for next year.
i just got done with a mammo, pap, ct scan, doc follow up and ALL of these will not be covered only by 20% now instead of 80 %
and about the meds.....i will have to pay all.
i am not a happy camper today finding out all about this now
9-02 crash w/ C-5-6-7 anterior/posterior fusion in neck w/11 screws and 4 metal plates. multilevel HNP at T & L section. FMS, PA in dec 05. on SSDI after 2.5 yr wait. sezuires, CTS, IBS ( C & D). norco, xanax, predisone shots. i dont know what else is wrong with me and neither does anyone else!!!


Ducky
Veteran Member


Date Joined Mar 2005
Total Posts : 3199
   Posted 6/15/2006 3:19 PM (GMT -7)   
Wow Missie, so sorry to hear all that... isn't there something you can do? Appeal it to somebody? Just seems as though they would've told you about this prior to? Thoughts and prayers are with you... Duck
Confirmed Diagnosis of - Psoriatic Arthritis/Spondylitis/Graves Disease/GERD/Scoliosis/Hiatal Hernia/Graves Disease of the Eyes/Chronic UTIs
Current Meds -  Enbrel/Prevacid/Synthroid/Nitrofurantoin
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CaMama
Veteran Member


Date Joined Mar 2005
Total Posts : 1884
   Posted 6/15/2006 7:16 PM (GMT -7)   

WOW, I'm really sorry they are putting you through this. That is something they should have told you right up front. You'd think that they are familiar with this situation and would be aware of informing potential patients this ahead of time!

Good luck and keep us posted if you can get refunded somehow.

**


 


SnowyLynne
Veteran Member


Date Joined Apr 2004
Total Posts : 1539
   Posted 6/15/2006 7:24 PM (GMT -7)   
Only thing is now if you want medicare part & B back you'll pay more.You should have kept it..................
SnowyLynne


missie1227
Veteran Member


Date Joined Nov 2005
Total Posts : 751
   Posted 6/18/2006 8:12 PM (GMT -7)   
i went to see the peeps at ss admin on friday. i told them of my problem of how no one told me that i needed to take the BACK premiums from june 1 2004, is when they approved me for medicare.....so now this means united health care will go back to june 1 2004 and open up all the meds doctros bills and re-adjust  each claim and take back the money paid out on them and tells me that i have to get  back on meidcare for the retroactive premiuns from june 1 2004.
i asked them if i can do this. they say they dont know. i asked to put me back on medicare part b and to make it retroactive from june 1 2004 and i will pay back premiums also. it is 2112.00 i have to pay for back premiums.
i had the option to do this after i got my notice of award in march but no one told me to do this, so i didnt. now i hope they will let me change my mind. they say they may. i hope so.
it seems i was the spouse of a NYS retiree who when we got marreid put me on his plan with united health care and in the regs, they say for ANY spouse of a NYS retiree MUST go on meidcare either when they are  under ssdi or reach age 65. since i am now ssdi, i have to take medicare no matter waht and will keep united health care as my Major medical, secondary ins to cover  what medicare doesnt. in other words, they went from paying 80% and being my primary to now being my secondary and paying 20% after medicare gets done.
part A is hospital and is free for me, but not part b. that is 88.00 monthly. united says they will keep on paying for my scripts through which is good.
so i dont need part D of medicare.
so a word to the wise...when you get ssdi, and are offered medicare after 24-29 months, if you are the spouse of a person who has you under their health care, call them up and find out if you ahve to switch before hand and dont do waht i did.!!!! nono nono sad
9-02 crash w/ C-5-6-7 anterior/posterior fusion in neck w/11 screws and 4 metal plates. multilevel HNP at T & L section. FMS, PA in dec 05. on SSDI after 2.5 yr wait. sezuires, CTS, IBS ( C & D). norco, xanax, predisone shots. i dont know what else is wrong with me and neither does anyone else!!!

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