<p>My mom was a dependent and also the surviving spouse (since 1/13) on my dad’s medical insurance. Since he was a federal employee, he chose to opt-out of enrolling my mom and himself in Medicare Part B when they each turned 65. They had their primary insurance with Kaiser. </p>
<p>After my dad passed in January, I took my 88-year-old mom to the doctor numerous times and, after she moved into a senior living facility in February, she has been transported to emergency several times as well. For 8 months Kaiser admitted her, administered treatment, and collected the co-pay. It was “business as usual” as far we both knew. </p>
<p>On 8/24/13, Kaiser sends me a letter stating my mom’s insurance was cancelled retroactively back to 3/4/13. First time I received ANY notification from them, even though my dad was admitted and died in their hospital. Also, the only notification I got from the government was a letter dated 1/31/13 that mostly talked about an overpayment of his pension, except for the last sentence that said his medical benefits had been “transferred to the Office Of Personnel Management (OPM)”. the letter contained nothing about termination of medical coverage. Kaiser said talk to OPM, since Kaiser wasn’t notified until 8/23, that there was nothing they could do. Nice way to treat a Kaiser member for 60-plus years…</p>
<p>Bottom line:
Was told my mom is not eligible for special enrollment in Medicare Part B and the general enrollment period to enroll is not until Jan-Mar 2014 for coverage beginning in July 2014. I have spoken to SS, Medicare, Kaiser, insurance brokers, attorneys, HICAP, CA Coverage, etc. and can not get them to make an exception. Adding insult to injury, Kaiser will be sending me a revised bill charging “nonmember rates” for the services rendered during the 8-months following my dad’s death. </p>
<p>I filed a formal grievance with Kaiser and OPM. In the meantime I am looking for any suggestions on how to get my mom insurance. Thankfully, she has Medicare Part A, but not having any other insurance until next July or August could be financially devastating and take a large chunk of her estate.</p>
<p>She’s not eligible for special enrollment in Medicare Part B because you waited too long after your father’s death, or because your parents didn’t enroll when they were 65 like they could have?</p>
<p>It sounds like the OPM should have spelled out exactly what was happening with your father’s benefits when he passed away. </p>
<p>I don’t fault Kaiser for not treating your mother for free. They can’t be in the business of giving free treatment to people who used to be members, particularly old, expensive people who used to be members.</p>
<p>Cardinal Fang, Correct, parents didn’t enroll in Part B at 65 since they had Kaiser as their primary insurance. My father obviously didn’t understand the consequences of non-enrollment upon his death since he thought my mom got to keep his insurance. Plus, there will also be PENALTIES of 10% per month for the 23 years since she was eligible for Medicare. Penalties of 1% for not having Part D as well.</p>
<p>What state are you in? CA has the HICAP program: Health Insurance Counseling and Advocacy Program. Trained volunteers are available at no charge to review insurance programs and counsel about Medicare programs. I believe other states have similar programs. They are amazing, knowledgable volunteers and it would be a good place to turn if you can find something similar.</p>
<p>takeitallin, Met with HICAP on Monday. They could not solve our problem. I did take their advice and sent an email to our Congressman (George Miller), CA district 11, asking for early enrollment, mentioning my dad was a veteran. Thanks for the good advice.</p>
<p>So, just to clarify the situation, jshain, what should your mother have done? Would she have been able to become a member of Kaiser immediately after your father’s death, at whatever expensive rate they charge to 88-year-olds? Is it possible to arrange that retroactively with Kaiser, on the basis that she obviously thought she was covered, and they might allow her to retroactively buy the policy she already thought she had? I suggest going up a couple of levels at Kaiser and seeing if you can negotiate something like that.</p>
<p>Cardinal, My mom was a Kaiser member for 60 plus years, but was a dependent on my dad’s/her husband’s insurance. When he died, the insurance “died”. I should have enrolled her in Medicare Part B immediately after my dad’s death in January. It would have cost $105.00 per month and, with penalties (23 years or 276 months times 10% additional per month), would have brought the premium to about $350 per month-- deducted from her monthly Social Security auto-deposits. She could have then obtained a Senior Advantage Plan at Kaiser, without any lapse in her medical coverage. As it is, no one will insure her without Medicare Part B.</p>
<p>If only I received notification or better understood how medical insurance for the elderly worked at the time. Expensive lesson.</p>
<p>I see. Kaiser would have enrolled her, but she would have had to sign up for Part B first. And (perfectly understandably) you and she didn’t realize she needed to do these things, and now nobody will let you do them retroactively.</p>
<p>But she can’t buy insurance now without Medicare Part B, and she can’t sign up for Medicare Part B until the next enrollment period. </p>
<p>I hope your experience can help someone else who might be facing the same situation. I would have made the same mistake.</p>
<p>I’m confused. I’m a retired federal employee and my husband is on my FEHB insurance. If I die, he can continue to stay on the plan because he will get a survivor annuity (from which they will deduct the premium). Was the problem that your mom didn’t have a survivor annuity? I know this doesn’t address the Medicare issue, but I don’t see why she doesn’t still have the Kaiser plan. What happened on 3/4/13 to cause them to cancel it?</p>
<p>patsmom, My dad’s FEHB was transferred to OPM. Not sure if “transferring” means cancelling or not. The OPM said that my dad didn’t “pay into” keeping my mom on his insurance. I have never heard of my mom having a survivor annuity. Once my dad died, Kaiser got notification from the OPM and Kaiser cancelled the insurance. It took the OPM 8 months to notify Kaiser, which caused her to miss the enrollment period for Medicare Part B. The 3/4/13 cancel date was 30 business days from the last day of the month in which he died. </p>
<p>If I were you, I would confirm that your husband will continue to be insured on your medical insurance in the event of your death because some fed agencies apparently cover surviving spouses and some don’t. Heck, if he is not 65 yet I would tell him to enroll in Medicare Part B upon your death. It’s money ($105 per month) well spent in case your hubby gets his medical coverage cancelled. The rules for federal employees re. Medicare Part B is vague at best. Medicare Part D (prescriptions) averages about $40 per month depending on coverages.</p>
<p>I just received and read my Welcome to Medicare booklet today. Starts Jan. 1.</p>
<p>I have no idea how federal government insurance works but I’m surprised Kaiser didn’t require your Dad to pick up part B when he went from employee to retiree status. The booklet clearly says only active employment or union insurance results in a part B special enrollment period with no penalty when that coverage ends. COBRA and retiree coverage do not. Of course who knows what info was provided 23 years ago or whenever your dad retired. My post 65 retiree coverage requires part B enrollment and then I get a supplemental policy and creditable drug coverage. This doesn’t help you but posting for anyone reading this thread.</p>
<p>patsmom, as long as the federal retiree has elected a survivor’s benefit for their spouse, FEHB will continue for that spouse after the retiree’s death. This is one of the main reasons married federal retirees choose a survivor’s benefit. Co-workers of my H, who is also a federal retiree, have debated the financial wisdom of taking the larger annuity (without the survivor’s benefit reduction) and using the extra dollars to purchase a big insurance policy with their spouse as the beneficiary. But the fear of losing their spouse’s ability to maintain their health insurance and the uncertainty that would bring generally outweighs taking the larger full annuity.</p>
<p>jshain, I’m sorry you and your Mom have to deal with this headache. I hope your Congressman can ease the way for you.</p>
<p>annoyingdad, My father actually was on worker’s comp with the Dept. of the Navy (OWCP) when he was 55. Not sure if that would be the same as going from employee to retired. At any rate, it appears that he did not pay a survivor’s benefit as IllinoisMom2006 mentioned in her post. When I spoke with the OPM representative on the phone, they mentioned that my dad didn’t “pay into” receiving the medical benefit for surviving spouse. I assumed they were referring to Medicare Part B which may or may not have been the case, now that I’ve read some of the comments above. The OPM is the absolute hardest phone call to get through on: line is busy for 8 hours, then recording comes on and says “call back next day, best hours to call are 8am to 11am eastern time”. Call back at 5am PST the next day and wait on hold 1 hour and 20 minutes.</p>
<p>Here are some links that might be helpful.
[OPM.gov[/url</a>] Check out the Life Events section for some Q&A that may apply.
[url=<a href=“http://www.opm.gov/retirement-services/]OPM.gov[/url”>http://www.opm.gov/retirement-services/]OPM.gov[/url</a>] The Retirement, Health and Life Insurance Publications link there might be useful.
(These two OPM links are different, even though they display the same inside this post)</p>
<p>I have a “renewed faith” in our elected officials… </p>
<p>Sent an email to Congressman George Miller’s website yesterday and received a phone call from one of his staff TODAY! The process involves lots of paperwork and documentation, but having a receptive ear from someone in Washington is giving me hope. All I’m asking for (at this point) is for special enrollment in Medicare Part B so I can get my mom medical insurance ASAP.</p>