Medicare and Employer Health Plans Can Cause Confusion

Some companies still offer their retirees a company health plan that supplements Medicare. Many people over 65 are still working and can choose to use Medicare or stay with their employer’s health insurance. These options can get confusing, especially when seniors sign paperwork they have not carefully read.

I heard from another insurance agent this week about two of her clients who are in a big mess over their company health plans and Medicare. I have two clients whose Part D applications got held up this week because of a retiree drug plan.

One lady is in her 80’s and has been enrolled in a Medicare Advantage plan for many years. She just found out she got enrolled in a Part D plan through her employer retirement plan – and that disenrolled her from her Medicare Advantage plan. She does not want to be disenrolled from her Advantage plan. She doesn’t know how she got re-enrolled in her company retiree plan, but she might have signed something she did not understand.

A man who is 70 years old has had a Medicare supplement and a Part D plan for three years.  He is still working for a fairly large employer, but back in 2009 he decided to use his Medicare and get a supplement instead of using his employer’s health plan. He just found out was re-enrolled in his employer plan last year – though he isn’t sure how this happened.  He thinks he may have signed some papers he did not understand. For the last year he has been paying for his Medicare supplement which is useless because his employer health insurance is primary and Medicare is secondary. But he had no idea about any of this until he got a bill for a hospital stay from 2012.

I have two clients whose Part D applications were rejected by Medicare because their Medicare record shows they have employer drug coverage. But these folks enrolled in a Medicare Advantage plan for January 1st and dropped their employer retiree plan as of December 31st. They are sure they did this, but they did it over the phone and no papers were signed.

This husband and wife enrolled in a Medicare Advantage plan, but soon decided they didn’t want Medicare Advantage. I told them they could use the Medicare Advantage Disenrollment Period (MADP) and go back to Original Medicare. To get them out of their Advantage plan, we submitted an application for a Part D plan and used the MADP “special election period”. But Medicare did not recognize that they have been in a Medicare Advantage plan since January 1st.  Yikes!

My clients were instructed to call Humana to say they dropped their retiree plan as of December 31st and enrolled in a Medicare Advantage plan. Humana will re-submit their Part D application to Medicare and….. hopefully… it will be accepted. But I’m worried about this because it seems like the Medicare Advantage Disenrollment Period code got lost in the shuffle. Yikes!

I will need to keep checking on this because they need to get enrolled in Part D in order to get out of their Medicare Advantage plan…..and they have paid for a Medicare supplement to start on February 1st. Yikes!  This is all very complicated.

People, young and old alike, are confused by health insurance. When Medicare and retiree plans get mixed up….. that can make for a confusing mess. Why is it all so complicated?

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