CASE FLASH:  MISTAKEN ENROLLMENT IN PART D

Ms. B did not want to enroll in the Part D prescription drug benefit because she had drug coverage from her former employer that was considered as good as Part D (“creditable coverage”). She received an application in the mail from Social Security offering Extra Help lowering her drug costs, so she filled it out. It was unclear to her that Extra Help is a federal program that helps pay for some or most of the costs of Part D. Ms. B was found eligible for Extra Help and was automatically enrolled in a private prescription drug plan (PDP). Not wanting this coverage, Ms. B disenrolled from the PDP. The next month, however, Ms. B was automatically signed up with another PDP because Medicare’s records indicated she still had Extra Help, which is available only to those enrolled in a Part D drug plan. After the third time this happened, Ms. B called her local State Health Insurance Assistance Program (SHIP) for help.

A SHIP counselor explained to Ms. B that to stop being enrolled in Part D plans, she would have to “opt-out” of the Extra Help benefit altogether. To opt-out, Ms. B needed to call Medicare’s consumer hotline at 800-633-4273 and ask specifically to speak to a benefits specialist. Ms. B would then need to explain to the benefits specialist that she wanted to opt-out of the Medicare Part D benefit and the Extra Help program. Ms. B followed these steps and, about a month later, received a confirmation letter that she had been completely disenrolled from Medicare Part D.

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Adapted from:  Medicare Watch, Vol. 10, No. 7: April 3, 2007, electronic newsletter of the Medicare Rights Center.