Insurance Issues

Shortly after the beginning of the year an official-looking envelope from my health insurance company showed up in the mailbox. When I opened it there was a letter that said that as far as Medicare was concerned I may have had a gap in prescription drug coverage for several months in 2024.

I knew that wasn't correct. Hubby Tony has good retiree insurance (which includes drug coverage). Each time I picked up a prescription all I had to pay was a small co-pay.

The letter said “If you did have prescription drug coverage you may be able to avoid the penalty by returning the enclosed form”. I filled out the form and took it to the post office the next day. Before I put the envelope in the slot I took a date and time stamped photo so I had proof.

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A month later I received a second letter that was identical to the first except for the deadline, which had been pushed back two weeks. As I had already mailed the information, I called the number listed on the form for guidance. I was told by an associate that there was no need to send it again.

This week I was quite upset to receive a third letter. It said that Medicare had determined that because they hadn't heard from me they were imposing a Part D (prescription) late enrollment penalty.

WTF!

I don't know if the insurance company or Medicare dropped the ball, but either way the outcome was unacceptable.

After spending some time yelling and screaming, I got busy proving them wrong. I filled out the Part D Late Enrollment Penalty (LEP) Reconsideration Request Form. Tony went to the health insurance website and downloaded a copy of the IRS document 1095-B which showed I was covered for the entire year. I also downloaded the details of my 2024 prescription claims and included that spreadsheet.

The documentation was to be sent to a third-party compliance company. I doubt that the person who opened the mail there would care about my predicament, but I also wrote a cover letter that included the details about the first two communications.

This morning I walked up to the post office, where I paid for a Priority envelope so I would have proof that it was delivered. Now I get to wait and see if they try to give me the runaround.

Five years ago today: If You Can't Find It New, Make It From Old