Ask Bob: How to Break a Social Security Logjam

Katy Votava, author of Making the Most of Medicare: A Guide for Baby Boomers, helps a Retirement Daily reader learn how to break a Social Security logjam.
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Question

I need some serious help. I was approved for Social Security Disability Insurance (SSDI) May 2020, and I called to find out if I needed to keep Medicare since I had private insurance through my wife on the Marketplace. 

I was told by a Social Security customer service representative that I did not need to keep it, and was sent a form to fill out to deny the 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 am not allowed to hold a Marketplace plan since I am eligible for Medicare. 

I called Social Security and 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 to keep my wife's insurance. 

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, 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, who is 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 in order to be able 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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Question

I need some serious help. I was approved for Social Security Disability Insurance (SSDI) May 2020, and I called to find out if I needed to keep Medicare since I had private insurance through my wife on the Marketplace. 

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