Ask Bob: How to Break a Social Security Logjam

By Robert Powell, CFP®, Retirement Daily, October 20, 2020

Question

I need some serious help. I was approved for Social Security Disability Insurance (SSDI) in May 2020. I called to determine if I needed to keep Medicare since I had private insurance through my wife on the Marketplace.
A Social Security customer service representative told me that I did not need to keep it and was sent a form to deny coverage. I did this and included all my insurance info on it. On July 6, I get a call from the Marketplace, stating that I cannot hold a Marketplace plan since I am eligible for Medicare. 

I called Social Security. They confirm this, review the form I needed to send in to cancel Medicare, and inform me that the woman who canceled Medicare was wrong in telling me I did not have to have Medicare and keep my wife’s insurance. Can you tell me if a Medigap policy would be of any value if I already have TRICARE with my Medicare? Our medications have gone from 0 to $20 a refill since Trump came in, can be $40 or higher, and some are not covered, although the doctor could find an alternative. Although not needed now, in the future, I could need rides to the doctor or meals.

Social Security tells me they will reinstate my Medicare immediately, and I must cancel myself off my wife’s plan. I do this, and it was canceled on July 31, 2020. As of today, I still do not have active Medicare. 

I speak to Social Security every single day, and all I hear is, “Oh, we forgot a section” or “Oh, we forgot to put this in,” and now I have no insurance coverage at all since August. I cannot refill my medication, which is extremely important. Two doctors are threatening to discharge me for not keeping appointments since I keep having to cancel for no insurance. I am having serious side effects now being off my meds. 

Help. 

Answer

Katy Votava, the author of Making the Most of Medicare: A Guide for Baby Boomers, recommends that you contact your Congressperson immediately to loosen up the log jam with Social Security processing. 

In the meantime, given that Medicare Part A and Part B will be retroactive to August 1, you should continue to keep your health care appointments, says Votava, also president of Goodcare.com.  

“Most health care providers will hold the billing until a situation like this is rectified,” she said. “You also need to let the health care provider know in advance about these circumstances and ask how they can accommodate them in the short term.” 

You also need to take your medications to manage through this trying time, says Votava. There are several options to get medication refills in the near term at the lowest possible out-of-pocket cost.  

Votava suggests that you recruit some assistance locally to help you through your short-term urgent need. Call 211. 211 is the most comprehensive source of locally curated social services information in the U.S., says Votava. They can recommend resources to assist you in your area. 

Some examples of ways to get medications refills at the lowest possible out-of-pocket cost until coverage is straightened out: 

– Ask the pharmacy for the lowest cash price without insurance. That might be lower than you think.

– Many pharmaceutical companies offer deep discounts for people in need without insurance. Go to the website for that medication or call the company’s 800# customer support line to ask about options.

– Look at pharmacy discount “cards” that offer lower-cost prescription medications through local pharmacies.

Got Questions?
Email Robert.Powell@Maven.io 

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