COBRA vs. Medicare Part B -- Help
I am a United States Social Security recipient who is torn over whether to disenroll from Medicare Part B before it kicks in in September 2010.
I am a kidney dialysis patient in Las Vegas, Nev., who currently is covered by a private insurance COBRA through my former employer -- a policy that pays my kidney dialysis center about $11,000 a week for three four-hour dialysis sessions.
The American Kidney Association pays my $500-a-month premium on my COBRA to the private insurance company, leaving me virtually no cost for my dialysis.
A social worker for my dialysis provider has told me that I am better off disenrolling from Medicare Part B before it becomes effective and keeping the COBRA for the next 18 months -- and then go on Medicare Part B when the COBRA's covereage ends.
A Social Security Administration representative told me that, in effect, the dialysis provider is looking after its own pocketbook and is misleading me into making a big mistake that will hurt me for many years beyond the life of the COBRA just so the dialysis company's profit line is not compromised by the lesser money it would be forced to accept from Medicare.
My kidney provider says that if Medicare B kicks in (at $110.50 per month out of my pocket), the COBRA's insurance company will drop me immediately to save itself from having to pay so much money, leaving the American taxpayer burdened with that cost through Medicare benefit payments.
A representative for the Social Security Administration, which is in the process of sending me the disenrollment form, says if I disenroll from Medicare Part B now, I will be subject to 10 percent monthly premium penalties for every year I do not have Medicare Part B from the scheduled first premium payment in September -- a penalty I will be forced to pay for the rest of my life.
(BTW, I never enrolled in Medicare. Enrollment, the SSA says, automatically kicks in two years after a client recieves his first Social Security monthly disability check.)
The SSA also says that, despite what I may have been told by the kidney dialysis provider and others, the private Insurance COBRA must pay for my dialysis treatment for the first 30 months regardless if I have Medicare B.
The kidney provider says that statement is false and that if the Medicare B deduction is taken out in September, the private insurance company will use that as an excuse to drop me from the COBRA plan at the end of that current month's premium and thus save itself from ever having to pay for my dialysis treatments again.
That, in effect, could leave me with no health insurance at all, should the SSA recieve my disenrollment form during that time period and disenroll me from Medicare Part B as well.
If the Social Security Administration is right and I go with the kidney dialysis provider's advice, I eventually would be burdening myself with small but potentially costly monthly Medicare premium penalties should I live another 20 or 30 years.
And, SSA says, I could find myself with a gap in insurance coverage as there are only a few months for which I will be allowed to apply for Medicare Part B in the future and for that covereage to kick in should I mis-time the end of the COBRA's coverage.
But if the kidney dialysis provider is right and I keep Medicare B, I could lose hundreds of thousands of dollars in benefit payments from the COBRA, which pays 100 percent of dialysis costs, and leave myself with potentially thousands of dollars in out-of-pocket liability because Medicare only pays 80 percent of the bill.
I am confused as to what to do and time is running out before Medicare B kicks in.
As a postscript for you to take into considration. I have already filed with SSA two forms asking to be disenrolled from Medicare Part B. But on my most recent call to the SSA (Aug. 9, 2010), the representative informed me that they have no completed disenrollment forms from me on file.
Please, someone, help me.
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