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New on this board. I am 47 y.o., but have been on disability for almost three years now. Honestly I have never fully understood many aspects of Medicare beyond the monthly premium for my Empire Blue Cross/Blue Shield Freedom II (PPO) plan.

I am not very good with paperwork and I have not had anyone (professional office, or other) assist me since I was approved for SSDI nearly three years ago.

I have actually been planning to find new providers. My main health/disability issue is psychiatric and I need psychiatric visits, mental health visits, and prescription medication covered at least in part. I was also about to go for a dental visit and I have put off for over a year some dental work (abutment and crown) that should be completed. Unrelated to those two issues, I now have a sinus infection which is worsening and it may need to be assessed and diagnosed (I've had sinus problems for almost 20 years).

Two months ago I received a letter that my current plan choice is going to be discontinued and unless I choose one by the deadline, I will be switched to original Medicare. I have meant to ask questions about this for several weeks, but haven't gotten back to doing so, until now. On Saturday, I received an unexpected bill from "Empire HealthChoice Assurance, Inc." for $480.00. Under the description and billing period information: "Direct Payment - Regular Billing" Direct Payment - Individual." Billing Period: 01/01/12 - 01/01/13. Excerpt from the reverse under Important Notices:
"Payment of this invoice is due in advance, upon receipt. The coverage will automatically terminate if we do not receive the premium by the end of a thirty (30) day grace period following the date the premium is delinquent."

When I saw this, I thought it was one of those bizarre, strange scams targeting Medicare recipients. (Early this year, I received some telephone calls and suspicious mail which I had since reported directly to Medicare and Empire at that time.) This does seem somewhat legitimate, but I don't understand it. First, the stated billing period would actually be retroactive (it starts in January 1, 2012) so the excerpted notice is confusing.

I have NO idea why I'm getting a $480.00 bill. I pay the monthly premium of $99.90 which is automatically deducted out of my monthly SSDI payment. If this is a legitimate bill, I don't have the money to pay in full this month. I rely on SSDI as my sole source of income. I can pay it over two months if I exclude other expenses (including food).

My first full year on Medicare was 2011 and it was uneventful and I thought I understood it. This new charge this year has completely baffled me.

Anyone with the patience to explain to me, I appreciate it. I don't understand any of this.

Lois Carmen D.
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Sounds like you might have received a bill for a medigap policy or a Medicare Advantage plan. I too am on SSD at age 62 due to heart issues. I pay $99/month for Part A, then about $350/month for medigap (medigap is much higher for those on Medicare due to SSD), and about $40/month for Part D drug coverage. If I were you, I would call you state SHIIP office and ask what's going on. They probably will be able to explain the situation, fraud or whatever. Good luck.
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I have NO idea why I'm getting a $480.00 bill.

Call them and ask. If you can't handle making that call, have someone make it for you.

Phil
Rule Your Retirement Home Fool
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I received an unexpected bill from "Empire HealthChoice Assurance, Inc." for $480.00.

The people to call is the one who sent you the bill. That sounds like Empire. Their phone number for questions may be on the bill. Or you might be able to ask by email or on their website.
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Sounds like you might have received a bill for a medigap policy or a Medicare Advantage plan. I too am on SSD at age 62 due to heart issues. I pay $99/month for Part A, then about $350/month for medigap (medigap is much higher for those on Medicare due to SSD), and about $40/month for Part D drug coverage. If I were you, I would call you state SHIIP office and ask what's going on. They probably will be able to explain the situation, fraud or whatever. Good luck.

ResNullius, I forgot to mention that I am calling from New York City. Even though there is a SHIIP (Senior Health Insurance Information Program) for the entire state, when we in NYC calls that number, we are routed automatically to local NYC, or 311. Unfortunately in the aftermath of Sandy, most all telephone calls to any city agency is swamped. I am going to wait until the end of the week, or next week (or beyond) to try getting through.

On the rest of your response, it all sounds reasonable except I don't know why I am getting this bill suddenly almost at the end of the plan year, essentially making this bill retroactive to the beginning of the year.

Also I've been paying (like you) $99.90/month via auto deduction out of my SSD check. I've not been billed $350/month yet for medigap. When I called moments ago, the awkward young customer service representative told me this was for "plan B" (emphasis on "B" and not "D"). It would have been more sensible to me if it was for "D."

Call them and ask. If you can't handle making that call, have someone make it for you.

Phil, I did. the phone number I have listed to Member Services is 1-866-395-5175. I called it a total of three times to be on the safe side. The very first two calls were greeted with this interesting robo greeting.

"Hello. Thank you for calling! Please listen carefully as the menu options may have changed. Congratulations! Just for calling in today, you’re going to the Bahamas on a complimentary two-night Bahamas cruise. Wow, this really is exciting! Your complimentary two-night cruise will include unlimited dining in the ship’s four spectacular restaurants, use of our luxurious on-board spa and health club, as well as access to one of the largest casinos on any cruise ship. Your only responsibility is nominal port fees of $59 per person payable to your credit card today. Congratulations again! I’m sure you’ll have a fabulous time on your Bahamas cruise. And it may be used any time in the next 18 months. I’ll connect you over to an agent that will give you all the exciting details. Press any touch tone now to hear all the details on the fabulous two-night Bahamas cruise. To be transferred to an agent who can advise you on how to schedule your travel dates, press any touch tone now."

At the first call, at the very end I hung up. I waited a few minutes again and it routed to that same greeting and I hung up by the first mention of "Congratulations!" I tried to call some other phone numbers I had or looked up, including state and city agencies that all seemed inundated at this point.

After about a half hour or more, I tried to call the same toll free number again, thinking perhaps I would get more of the same, or just see something else. I might strike some as being paranoid at this point, but I decided to go through the call. Oddly, this time it went through a legitimate sounding voice mail system. After several buttons were pushed and several more minutes on hold, a young awkward woman answered and attempted to help me. She took down my name and some of my information, including my phone number. After speaking with her for a few minutes and being put on hold a couple of times, I hung up on one point. She called back, twice. When questioned on the specifics of the bill (which is apparently supposedly to pay for the Plan B portion, but she understood little else of Medicare it seemed), she had to keep checking with someone else for an explanation. No doubt I regret 'confirming' my telephone number at the initial part of our call.

It could be too many near-misses with odd pieces of mail and phone calls in which at least three were confirmed scams or masquerading as legitimate Medicare of Empire Blue Cross/Blue Shield, or attempts to erroneously bill Medicare for services I never requested or received, I wonder if this is the one of the more sophisticated scams which pose as officious sounding invoices. I still remember from the 1980s all the "yellow pages" directory listings or related that some small business people I knew who were being charged for advertising that they did not understand and had no relevance to. I just feel very uncertain about whether this is a justifiable bill whatsoever. I would have thought it was more credible if I had gotten at the beginning of the year, not the end. It doesn't encourage me when I hear generally about FBI fraud bureaus on the constant vigilance for Medicare scams.

And yes, I initiated the call, but I didn't trust it, yet still went through with it. I'll note that the number was on this invoice. Could it be a clever scam? Or am I overworked over nothing, beyond agitation at getting an unexpected and large bill? I have a hard time trusting any phone calls anymore, as well as paperwork.

I will have to wait until I called an appropriate NYS/NYC Medicare office, but I may also call one of the various numbers for SSA on this.

Lois Carmen D.
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Medicare Part A is free (rather, you paid for that through your Medicare contributions while working). The $99.90 per month is for Medicare Part B.

I agree with ResNullius regarding calling the state SHIP office to see what's going on.

Donna
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Your Medicare advantage is from Empire Blue Cross and they are the ones who sent you the bill. So I would call them first.

If the phone number on the bill is incorrect, I'd call Empire at the number on your Empire insurance card.
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