Napa's Health Insurance Guys: She missed her Medicare payment. Now what?

Dear Kyle, Tom and Alan:

I ran into something I haven't seen in your column before. I'm retired, age 67, not taking Social Security yet, and somehow missed paying my premium for Medicare Part B! My bill for $494.70 (that's 3 months at $164.90 per month) got lost in the mail and didn't get paid.

Anyway, I didn't even think about it until I got a letter from the government saying my Part B was canceled for non-payment. Even worse, my Medicare Supplement plan was canceled because you have to have Medicare A and B in place in order to have a "Medigap" plan.

It was small consolation to be told that my prescription drug plan is fine due to the fact that you only need A or B for that instead of A and B.

Since I basically have no medical coverage, what can I do?

Madge

Kyle: OK, this is different. Usually, people contact us when they are late enrolling in Part B, not when they've had it and then lost it! The standard is a 10% penalty for each 12-month period you could have had Part B but didn't. So, Madge, if it takes 12 months to get it sorted out with Social Security, you might be facing a monthly fine of $16.94 that never goes away.

If you're one quarter behind, you can ask to be re-instated through Social Security and they may consider it.

Alan: Our most recent case similar to Madge's, was a customer that went through most of this year without paying Part B. He was told that there was likely no appeal possible and that he could not sign up again for Part B until January. He could then sign up for a Medigap plan.

A potentially huge problem will be that he is well beyond the six-month guaranteed issue benefit after turning 65, so he will have to answer all medical questions on the application and could be declined. To add insult to injury, the Part B premium is going up next year to $174.70…so the monthly penalty would be $17.47.

My understanding is that Kaiser Senior Advantage would be available to him since it is our only 5-star rated plan. The Center for Medicare and Medicaid Services (CMS) comes out with the star ratings each October for Advantage and Rx plans.

Tom: It looks like our recommendation for Madge is that she throw herself on the mercy of Social Security to see if she can make back payments to reinstate with Part B. If not, do all she can to get current.

Kyle: By the way, the Annual Enrollment Period (AEP) is still going strong until Dec. 7. Now is the time to explore drug plans and advantage plans. Yes, Wellcare still has an Rx plan with a premium of only 40 cents per month; Wellcare also has a plan with no deductible for those taking brand-name drugs.