Friday, September 11, 2009
Enrolling in Medicare
Now, just because Congress was in recess and not much happened with the beast that has taken over much of my life in the past month, don't think I've been sitting around playing video games all month! (Although I have to admit I've done my share of that!) I've been quite busy, meeting with my new Prosthetist, visiting burn survivors in the burn unit, getting involved with both burn and amputee support groups, but the biggest thing was that I was finally able to put one very important issue to bed.
I'm finally on Medicare. (Now, I've had the Medicare Hospital insurance ever since I was approved for Social Security Disability, but I had turned down the Health Care portion because I was still covered by my employers plan. Now that I am no longer employed, COBRA is getting too expensive and I needed to make a change.) The easy thing for me to have done would've been to sign the enrollment form during the normal enrollment period at the beginning of the year. (Once you're eligible for Medicare they send you a form to enroll between January 1st and March 31st, which is the normal enrollment period.) Could I do it the easy way? No, of course not!
At the beginning of the year I was paying into COBRA, which is not cheap, but decided to wait on enrolling for Medicare, because our President's stimulus package was supposed to make COBRA more affordable. I wanted to wait to see which would be the better financial option for me. (I should have known better!) I contacted Medicare to find out if I could wait until the information about the stimulus package was released, and they gave me an extended enrollment period because I wasn't technically unemployed until the beginning of this year. Ultimately, of course, the reduction in COBRA cost from the stimulus package did not apply to me because I'm eligible for Medicare. (Would have been nice to know that up front!)
When I finally made the decision to enroll in Medicare I contacted the Social Security office. (They handle enrollment.) I had assumed I would just need to send in the enrollment form, but they needed additional information from my previous employer. (Again, would have been nice to know this when they extended my enrollment period!) So, with very little time left I managed to get the paperwork they needed, send it to my old employer in California, get it signed and sent back to me, and then hand deliver it to the Social Security Office.
Once I had delivered the paper work I assumed that everything was done, and for the most part it was, but several weeks went by and I hadn't received anything confirming that I was on Medicare. I finally started making calls. The folks at Social Security were able to confirm that I was enrolled, but in the process I uncovered a bigger issue. Somehow Medicare had gotten a hold of information about the accident and they had the other drivers auto insurance listed as the "liability insurance" for anything related to injuries from that "incident". What that means is that they would deny any claims related to my amputations. Adjustments to my prostheses, future physical therapy, wheelchairs, etc... I have very few medical expenses that are not related to that "incident"!
Now, you should know that the other drivers auto insurance did pay out the maximum on her policy in the very early days after the accident. You should also know that the maximum on her policy, while it was a substantial amount that is standard on most auto insurance policies, was eaten up by the first week of medical expenses. That policy was exhausted long ago. Of course, Medicare would not take my word for it when I informed them that their information was wrong. I had to track down the other driver's insurance agent and get them to fax a letter to medicare informing them that the policy in question no longer existed.
It took a few days to reach the insurance agent, and I assumed this would take a long time to work out. To my surprise, once I had spoken with the agent, I had a copy of the fax in my email less than 20 minutes later! From what I understand it takes a full week from the point a fax is received by Medicare for someone at Medicare to actually look at it. I'm not positive that the whole thing has been worked out yet but, if not, it will be soon.
Obviously this is an important issue to get straightened out, but I want to be sure you understand my sense of urgency here. I've been working with my new Prosthetist on getting new sockets for my legs. Hopefully the new sockets will allow me to fix several issues that I have been dealing with when walking. Also, this should allow him to start making the adjustments that may give me the ability (or potential ability) to walk without crutches! I've already had the fitting for the new sockets, sockets that I will be able to customize in regards to appearance. The process includes several stages, but I should have the new sockets in about 6 weeks. I'm very excited, and I promise to keep you informed as we go on this ride together!
Glad the driver's insurance agent was so prompt. When you can work with a person it is so much nicer and also much more effective.