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ssdi/medicare/other insurance

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fmccarthy

Member
What is the name of your state (only U.S. law)? FL

My wife recently was approved for SSDI after an ALJ hearing. As anyone familiar with the process knows, it's a 2 + year process. Today we were shopping for Medicare supplement insurance since Medicare is to kick in at some point. One of the reps asked when it would start and we assumed Jan or even Feb. depending on SSA processing. He said to call SSA because of differing enrollment deadlines. Good advice! We found out that she had Medicare since August but we didn't know about it. Obviously this has an effect on the deadline for enrollment in supplementary plans. However, we are in a double insurance situation.

We have had a commercial, self-paid policy with Aetna. Claims have been paid this Fall. Now we find that, even though we didn't know we had it, Medicare was in effect and the part B premiums will be withheld - 5 months worth - from her first check in Jan. I gan grasp how this happened. A 2 year wait or the hearing, which approval puts eligibility back 2 + years; Medicare kicks in (obviously automatically) after 2 years of eligibility. Problem is, we've paid for two policies for the past 5 months.

Getting money back from Aetna would be a bear as we would have to get the Dr.'s to cancel the prior payment, re-bill Medicare and then have Aetna act as the 20% supplement since then. I can imagine they would conveniently charge as much for that as having her on my regular policy, the voodoo math usually applied to insurance refunds notwithstanding.

I am wondering if one can request SSA move that Medicare date to 1 Jan and refund/not withhold the premiums for the Aug-Jan period since we had no knowledge of the action, and the Aug date artificially applied since she wasn't eligible in August for August. Does anyone have any experience with this?
 



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