Sorry for the length of this post, but I think the background may be helpful/necessary.
So, my Dad retired from P&G in January 2011 at the age of 66. They brought in an outside person to help with the retirement preparations, including P&G's retiree health plan (through United Healthcare), but she was not at all helpful. My Dad made an appointment with her and when he showed up, she claimed she didn't have record of the meeting, and handed him some paperwork in connection with the healthcare. My Dad reviewed it, and believed that with Part A and his P&G retiree plan did not need Part B (I think you can see where this is going).
For the past 4 years, he's had no health issues that required Part B services. However, last week he was diagnosed with stage 3 colorectal cancer (potentially stage 4 as there's a tiny spot on his liver that has to be PET scanned). We did not discover the need for Part B until we were leaving the doctor's office, and the woman who handles the insurance dropped the bomb on us that his P&G plan covers only 20% of the services and that "he needs to sign up for Part B right now."
Of course, the general enrollment period is over (we missed it by a mere 6 weeks), and it appears that he does not qualify for the special enrollment period/special elections. So right now, his only choices are to get the treatment he needs and completely bankrupt himself (although there may be some blessing in that my parents don't have a lot to begin with), or delay treatment for 14 months until he can enroll during next year's general enrollment period, and wait for the benefits to begin on July 1st, and hope that his cancer doesn't kill him before then or progress beyond the point of no return.
We're trying through one of our Senators and a Congressman (we're in PA) to get some help (the Senator's office said straight out there's no exception to the enrollment period, although afterward they did send us some paperwork to fill out and said they'll attempt to help, and the Congressman's office said that appeals have been granted, but that sometimes they say "you should have read the paperwork" and deny the appeal, which I'm very afraid will happen in this instance). My mother was told by someone at Medicare to keep calling the SSA and be persistent, because even though they say they don't grant exceptions, they do, and they don't want to see people go without treatment (at this point, I don't know how much I believe that either, because we've heard nothing but "no" at every turn!).
So, my question is, does anyone have any experience/advice with respect to a situation such at this? My Dad is very upset with himself. He thought he'd done everything right, only to find out otherwise the very hard way. He's aware of the penalty for late enrollment and obviously understands it and has no problem with it, and he's more than willing to pay the few thousand dollars in premiums he would have paid had he enrolled upon retirement.
Also, is there any obligation for an employer to notify retirees of this very critical obligation to enroll in Part B, because my uncle - my Dad's brother - also retired from the same P&G plant in 2013, also was never told he had to enroll in Part B, and believed that he was fully covered by Part A and the P&G plan. Needless to say, he's going to enroll during the next general enrollment period, and cross his fingers that he doesn't require any Part B services before July 1, 2016.
So, my Dad retired from P&G in January 2011 at the age of 66. They brought in an outside person to help with the retirement preparations, including P&G's retiree health plan (through United Healthcare), but she was not at all helpful. My Dad made an appointment with her and when he showed up, she claimed she didn't have record of the meeting, and handed him some paperwork in connection with the healthcare. My Dad reviewed it, and believed that with Part A and his P&G retiree plan did not need Part B (I think you can see where this is going).
For the past 4 years, he's had no health issues that required Part B services. However, last week he was diagnosed with stage 3 colorectal cancer (potentially stage 4 as there's a tiny spot on his liver that has to be PET scanned). We did not discover the need for Part B until we were leaving the doctor's office, and the woman who handles the insurance dropped the bomb on us that his P&G plan covers only 20% of the services and that "he needs to sign up for Part B right now."
Of course, the general enrollment period is over (we missed it by a mere 6 weeks), and it appears that he does not qualify for the special enrollment period/special elections. So right now, his only choices are to get the treatment he needs and completely bankrupt himself (although there may be some blessing in that my parents don't have a lot to begin with), or delay treatment for 14 months until he can enroll during next year's general enrollment period, and wait for the benefits to begin on July 1st, and hope that his cancer doesn't kill him before then or progress beyond the point of no return.
We're trying through one of our Senators and a Congressman (we're in PA) to get some help (the Senator's office said straight out there's no exception to the enrollment period, although afterward they did send us some paperwork to fill out and said they'll attempt to help, and the Congressman's office said that appeals have been granted, but that sometimes they say "you should have read the paperwork" and deny the appeal, which I'm very afraid will happen in this instance). My mother was told by someone at Medicare to keep calling the SSA and be persistent, because even though they say they don't grant exceptions, they do, and they don't want to see people go without treatment (at this point, I don't know how much I believe that either, because we've heard nothing but "no" at every turn!).
So, my question is, does anyone have any experience/advice with respect to a situation such at this? My Dad is very upset with himself. He thought he'd done everything right, only to find out otherwise the very hard way. He's aware of the penalty for late enrollment and obviously understands it and has no problem with it, and he's more than willing to pay the few thousand dollars in premiums he would have paid had he enrolled upon retirement.
Also, is there any obligation for an employer to notify retirees of this very critical obligation to enroll in Part B, because my uncle - my Dad's brother - also retired from the same P&G plant in 2013, also was never told he had to enroll in Part B, and believed that he was fully covered by Part A and the P&G plan. Needless to say, he's going to enroll during the next general enrollment period, and cross his fingers that he doesn't require any Part B services before July 1, 2016.
