I'm looking for a supplemental policy for my Mother (85). She has the Federal Standard BCBS policy and does not qualify for Medicare. Any suggestions, anyone?
Total Comments: 7
Posted: Sat Nov 08, 2008 07:38 pm Post Subject:
Hi "me." Welcome to the forum! It would be great if you could give us a little more info so that we might be able to help you out.
When you say "supplemental policy," that could mean a number of different things. From your post, I think you probably mean supplemental medical expense (health) coverage?
Secondly, why is it that she doesn't qualify for Medicare? It's pretty unusual that a person wouldn't qualify so I'm interested in what's going on behind that.
Finally, if you could let us know where you live and some details about Mom's financial picture, I think we might be able to help. Thanks.
InsTeacher 8)
Posted: Mon Nov 17, 2008 05:08 am Post Subject: Excellent Question
I'm no expert on Medicare, but I'm curious why an 85 yr-old American citizen living in the U.S. could not qualify for Medicare.
Also, if she can't it would seem like she needs more than just a supplemental policy. Sounds like she needs basic coverage - something like Medicare Parts A & B.
Let us know, ME!
Posted: Mon Nov 17, 2008 06:38 am Post Subject:
Yup, its quite unusual for an elderly American not to qualify for Medicare. I too was wondering what might have remained as the cause for this. However, one might not qualify for the Medicare if she or her spouse hasn't worked in Medicare qualifying employment for at least ten years. This condition can bar an individual from enjoying the benefits of government funded Medicare plan.
Posted: Tue Nov 18, 2008 03:16 am Post Subject:
Since "me" hasn't replied, a couple of comments.
You guys are right. It is highly unlikely that almost any American citizen age 65 or older be denied Medicare. It's almost HARD to not qualify. Even if you don't have enough Social Security quarters of coverage (also know as "work credits"), you can normally qualify in a myriad of other ways. So, that's the part I want explanation on.
It normally works like this, in a simple explanation. Every calendar quarter that you work and pay into the S.S. system, you'll earn a work credit aka quarter of coverage. So, four credits per year. In order to receive Part A of Medicare (hospital portion) "premium free," you must have amassed at least 40 quarters of credit, or in other words- paid into the system for at least 10 years. That refers to Jeorges' comment:
However, one might not qualify for the Medicare if she or her spouse hasn't worked in Medicare qualifying employment for at least ten years.
You can also qualify based on your spouse' SS earnings in most cases, and even if you don't qualify there, other ways are available. You can purchase Part A if you don't qualify for the "at no premium" coverage. There's all sorts of info available at the fed guvmint's S.S. site:
You can start here at the S.S.A.: http://www.ssa.gov/
For specifics on Medicare: http://www.ssa.gov/pgm/links_medicare.htm
InsTeacher 8)
Posted: Wed Nov 19, 2008 05:06 am Post Subject: insurance
I'll give ya'll a little 'tid-bit'. I work with the Elderly, as my job. ONE woman 'qualifies' for Medicare, however......the OTHER one does NOT. They are both in their 60's. I don't know why the OTHER woman CANNOT 'qualify'. Apparently, it's a 'personal issue' ( according to her Caseworker..) and I'm not allowed to know why. If she goes to the Emergency Room for something, their is a program that will help her with her ER bill. However.......Dr's appts, etc.....she is just out of luck. I really 'feel' for her.
Posted: Thu Nov 20, 2008 06:11 am Post Subject:
Apparently, it's a 'personal issue' ( according to her Caseworker..) and I'm not allowed to know why.
I think you probably know the reason why you can't get any information- it's protected by HIPAA. HIPAA will allow you access to her information if you have her sign a HIPAA waiver form naming you as an additional person allowed to see the records. She can limit the type and amount of information that would be available to you on the waiver form, and can also limit the length of time the form is valid.
I asked a Medicare expert friend of mine why certain people who otherwise appear to qualify simply don't qualify. He said there are normally only two reasons:
1. The person cannot qualify due to not enough work credits for either themself or their spouse, and cannot afforde the premiums for parts A and B, and;
2. Although rare, anyone convicted of Medicare or Medicaid fraud may lose their Medicare/Medicaid rights.
This is copied from the Federal Register: http://edocket.access.gpo.gov
SUMMARY: This annual notice announces Medicare's Hospital Insurance
(Part A) premium for uninsured enrollees in calendar year (CY) 2009. This premium is to be paid by enrollees age 65 and over who are not
otherwise eligible for benefits under Medicare Part A (hereafter known
as the ``uninsured aged'') and by certain disabled individuals who have
exhausted other ntitlement. The monthly Part A premium for the 12 months beginning January 1, 2009 for these individuals will be $443. The reduced premium for certain other individuals as described in this notice will be $244.
DATES: Effective Date: This notice is effective on January 1, 2009.
There are also monthly premiums for just about everyone else for Part B, too.
InsTeacher 8)
Posted: Fri Nov 21, 2008 02:11 am Post Subject: insurance
OH YEA.......I understand the HIPAA. I deal with it ALOT. That's the problem ,too. The 'client' doesn't have any family, in the area, and she won't sign a 'waiver'. I can't blame her, though. I don't know if I would, either. ) I think (?) her POA is a good friend of hers.
Posted: Sat Nov 08, 2008 07:38 pm Post Subject:
Hi "me." Welcome to the forum! It would be great if you could give us a little more info so that we might be able to help you out.
When you say "supplemental policy," that could mean a number of different things. From your post, I think you probably mean supplemental medical expense (health) coverage?
Secondly, why is it that she doesn't qualify for Medicare? It's pretty unusual that a person wouldn't qualify so I'm interested in what's going on behind that.
Finally, if you could let us know where you live and some details about Mom's financial picture, I think we might be able to help. Thanks.
InsTeacher 8)
Posted: Mon Nov 17, 2008 05:08 am Post Subject: Excellent Question
I'm no expert on Medicare, but I'm curious why an 85 yr-old American citizen living in the U.S. could not qualify for Medicare.
Also, if she can't it would seem like she needs more than just a supplemental policy. Sounds like she needs basic coverage - something like Medicare Parts A & B.
Let us know, ME!
Posted: Mon Nov 17, 2008 06:38 am Post Subject:
Yup, its quite unusual for an elderly American not to qualify for Medicare. I too was wondering what might have remained as the cause for this. However, one might not qualify for the Medicare if she or her spouse hasn't worked in Medicare qualifying employment for at least ten years. This condition can bar an individual from enjoying the benefits of government funded Medicare plan.
Posted: Tue Nov 18, 2008 03:16 am Post Subject:
Since "me" hasn't replied, a couple of comments.
You guys are right. It is highly unlikely that almost any American citizen age 65 or older be denied Medicare. It's almost HARD to not qualify. Even if you don't have enough Social Security quarters of coverage (also know as "work credits"), you can normally qualify in a myriad of other ways. So, that's the part I want explanation on.
It normally works like this, in a simple explanation. Every calendar quarter that you work and pay into the S.S. system, you'll earn a work credit aka quarter of coverage. So, four credits per year. In order to receive Part A of Medicare (hospital portion) "premium free," you must have amassed at least 40 quarters of credit, or in other words- paid into the system for at least 10 years. That refers to Jeorges' comment:
However, one might not qualify for the Medicare if she or her spouse hasn't worked in Medicare qualifying employment for at least ten years.
You can also qualify based on your spouse' SS earnings in most cases, and even if you don't qualify there, other ways are available. You can purchase Part A if you don't qualify for the "at no premium" coverage. There's all sorts of info available at the fed guvmint's S.S. site:
You can start here at the S.S.A.: http://www.ssa.gov/
For specifics on Medicare: http://www.ssa.gov/pgm/links_medicare.htm
InsTeacher 8)
Posted: Wed Nov 19, 2008 05:06 am Post Subject: insurance
I'll give ya'll a little 'tid-bit'. I work with the Elderly, as my job. ONE woman 'qualifies' for Medicare, however......the OTHER one does NOT. They are both in their 60's. I don't know why the OTHER woman CANNOT 'qualify'. Apparently, it's a 'personal issue' ( according to her Caseworker..) and I'm not allowed to know why. If she goes to the Emergency Room for something, their is a program that will help her with her ER bill. However.......Dr's appts, etc.....she is just out of luck. I really 'feel' for her.
Posted: Thu Nov 20, 2008 06:11 am Post Subject:
Apparently, it's a 'personal issue' ( according to her Caseworker..) and I'm not allowed to know why.
I think you probably know the reason why you can't get any information- it's protected by HIPAA. HIPAA will allow you access to her information if you have her sign a HIPAA waiver form naming you as an additional person allowed to see the records. She can limit the type and amount of information that would be available to you on the waiver form, and can also limit the length of time the form is valid.
I asked a Medicare expert friend of mine why certain people who otherwise appear to qualify simply don't qualify. He said there are normally only two reasons:
1. The person cannot qualify due to not enough work credits for either themself or their spouse, and cannot afforde the premiums for parts A and B, and;
2. Although rare, anyone convicted of Medicare or Medicaid fraud may lose their Medicare/Medicaid rights.
This is copied from the Federal Register: http://edocket.access.gpo.gov
SUMMARY: This annual notice announces Medicare's Hospital Insurance
(Part A) premium for uninsured enrollees in calendar year (CY) 2009.
This premium is to be paid by enrollees age 65 and over who are not
otherwise eligible for benefits under Medicare Part A (hereafter known
as the ``uninsured aged'') and by certain disabled individuals who have
exhausted other ntitlement. The monthly Part A premium for the 12 months beginning January 1, 2009 for these individuals will be $443. The reduced premium for certain other individuals as described in this notice will be $244.
DATES: Effective Date: This notice is effective on January 1, 2009.
There are also monthly premiums for just about everyone else for Part B, too.
InsTeacher 8)
Posted: Fri Nov 21, 2008 02:11 am Post Subject: insurance
OH YEA.......I understand the HIPAA. I deal with it ALOT. That's the problem ,too. The 'client' doesn't have any family, in the area, and she won't sign a 'waiver'. I can't blame her, though. I don't know if I would, either. ) I think (?) her POA is a good friend of hers.
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