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Subject:  Medicare: $480 bill, choosing new plan Date:  11/5/2012  10:57 AM
Author:  lcd186 Number:  18048 of 22742

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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