Cancelling and reinstating Medicare B

[doowon]

Hello,

My father is over 65 and has medical coverage with Kaiser Permanente which he gets through my mother. He has developed a rare and aggressive form of throat cancer that Kaiser has never treated before. Rather than becoming their test subject, we have found a medical facility in Texas more experienced with treating his cancer. Unfortunately it was outside of Kaiser network. So we applied for Medicare B with a plan to cancel Kaiser. We were told by Social Security personnel that Medicare will cover his expenses. However, it turns out that as long as my mother is with us, he won't be covered by Medicare. We wanted to cancel or put Medicare B on hold until needed, but it is our understanding that once cancelled, it can not be reinstated. Our problem is, if my mother passes before my father, he will be left without any medical coverage. My father's Medicare B was activated on 09/24/14. I was wondering if there was a way to put his Medicare coverage on hold without it being permanently cancelled.

Thank you,

Sunny

 

[Mack]

I am sorry but I can not answer your question. My first impression is that if your father is eligible for medicare on his own then it shouldn't matter about other coverage. Also I do not know about putting Medicare "on hold". Why not just leave it in place, even if he has other coverage?

My best advice is to contact Medicare directly and deal with them as only Medicare can answer your questions and make the decisions. Be sure to talk to someone at a higher level who has knowledge and authority to make decisions. Call 1-800-Medicare and be patient, it may take a while to get to the right person, but someone will give you the answers.

 

[doowon]

Thank you for your reply!
The reason we don't want to keep Medicare B as a secondary coverage is the monthly cost. We've gone to their office several times to get some straight answers, but to no success. We'd get a different answer with every new personnel we talked to or they'd give up downright wrong information. I guess talking to someone higher up would be our best option. Thank you again for your reply and suggestion.

 

[Mack]

Good luck to you and do post back with the solution, as others may be in the same situation.

 

[mattspits]

Sunny,

Sorry to hear about your situation. Your experience with Medicare does not surprise me. Especially around this time of year they do a lot of hiring to help with all of the plan changes that take place during AEP. Many of them are literally reading from a script. You definitely should be asking for a supervisor.

Let me address your question the best I can. Im not familiar with Kaiser, but if he is enrolled in a PPO than he should still be able to access benefits outside of the network, but at a higher cost. If he is in an HMO he would not have access to care outside of the network.

As far as Medicare is concerned, yes, they do cover regardless of network assuming the facility takes Medicare, but they would not be covering at 100%. They have a large deductible for hospital care as well as an 80/20 split with not Maximum out of pocket for care he would receive. You definitely would want him to have a Medicare supplement along with Medicare.

His Part B is always effective on the first of the month so he signed up on 09/24 than his effective date is 10/01/14. What you stated about your mother being involved does not make any sense. If his care is through your mother than he is not the primary. Most plans want to remove people off of their coverage, and not keep them. I would expect that he should be able to drop Kaiser with no repercussions involving your mother. He should than be able to sign up for a Medicare supplement and receive the care he needs.

If he was the primary insured, than him dropping Kaiser would force your mom off Kaiser as well, but that is not what you said, so you may want to revisit this situation with Kaiser instead of trying to remove the Medicare.

Also, keep in mind that Medicare supplements have a 6 month guarrantee window that starts with his Part B effective date. Now that the Part B is in effect you should focus on getting him into a supplement and off of Kaiser before the guarantee window is gone.