HRA guide: Medicare Part B premiums
The Ohio Public Employees Retirement System uses a reimbursement process administered by OneExchange to help participants in the OPERS Medicare Connector pay their expenses.
Today’s blog addresses how to pay Medicare Part B premiums and be reimbursed through your HRA account. Medicare Part B premiums cover doctor’s visits as well as some lab work, X-rays, therapy and durable medical equipment. You can view an accompanying video series on our YouTube channel.
Paying your bill
- You pay Medicare for Med B insurance. It can come out of your monthly Social Security check, if you receive this benefit. If not, you pay the premium directly to Medicare by check or credit card.
- You have the option of setting up payments to occur monthly, quarterly or yearly.
Getting your money
Connector participants can be reimbursed for the portion of their Med B premiums that OPERS doesn’t cover. The $31.81 that OPERS provides ends next year.
Medicare Part B premium reimbursements can be set up on a recurring basis once a year. Submit the recurring claim form to OneExchange to have the money sent to you from your HRA account.
Verifying your claim:
You’ll need to document your expenses. Make sure your submitted documents include:
- The covered participant’s name
- The insurance provider name
- The date of service
- A description of coverage (for example, Medigap)
- Proof of payment
When you seek reimbursement, your proof of payment can include:
- A copy of the benefit award letter you receive each fall if you receive Social Security benefits
- A proof of income letter
- A portion of the premium invoice, if you pay Medicare directly
Next topic: OPERS-sponsored insurance
Michael Pramik
Michael Pramik is communication strategist for the Ohio Public Employees Retirement System and editor of the PERSpective blog. As an experienced business journalist, he clarifies complex pension policies and helps members make smart choices to secure their retirement.
Can I file bi-monthly on the preminums, as my funds won’t cover from Janurary to may.
Barbara,
Yes, you can. Also, if you file for reimbursement for any expense, and there is not enough in your account when the request is processed, they will send you what’s in the account at that time and send the rest later.
–Ohio PERS
One Exchange had great customer service. Great service until we signed up. From that point forward having issues resolved by One Exchange has taken many phone calls and several hours on the phone.
I can definitely relate to this. Nothing has messed up my checking account worse than this. Money in some days out if they feel like paying it. All this faxing to get reimbursed and even if you send all the paperwork. Which means. Coping your checking account statements to prove payment. They reject it and you have to send over.
I have had no problems with One Exchange. They have always been very helpful to me.My health premiums are taken out of my checking account and reimbursed by One Exchange from my HRA.
Patricia
I am pleased that you have not had any issues. When we call One Exchange we anticipate being on the phone for over an hour, talking to 3 or 4 people; being told that no one person has access to my entire file. I have to do the coordination. We chose not to do automatic reimbursement as we do not have any faith that it will be done correctly. They may have the system working in a year or two.
In addition, our EOB has a software glitch that does not allow it to print correctly. Apparently there is no oversight on the quality of printing that One Exchange is sending out.
Payment of Part B premium. I receive a quarterly bill (NOTICE OF MEDICARE PREMIUM PAYMENT DUE) from the US DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE AND MEDICAID SERVICES. This is the only paperwork received by me. There is no receipt. I mail a check for the quarterly payment to Medicare Premium Collection Center.
What is the RECURRING reimbursement process for this QUARTERLY payment?
Currently, I have to wait for the cancelled check…print out a copy, front and back, make a copy of the NOTICE OF MEDICARE PREMIUM PAYMENT DUE, fill out a one time reimbursement form and fax to OE. Currently, I do this on a quarterly basis. Again, what is the process for RECURRING reimbursement for this quarterly payment?
Lucy,
Use the recurring reimbursement form on the OneExchange/OPERS website. If you pay Medicare directly for the Med B premium, you can use your invoice as a receipt.
–Ohio PERS
Michael: I believe that One Exchange does not accept the Medicare Invoice. You should research this issue. Not everyone wants to use the automatic reimbursement option. Bill
Bill,
A OneExchange representative got back to us yesterday after I asked them about your issue.
She said OneExchange needs the following information to process Medicare Part B claims:
* The benefit recipient’s name
* The date or dates of coverage for Medicare Part B
* The amount paid for Medicare Part B
* The proof of premium (the coupon or statement from Medicare) or the Social Security benefit award letter clearly stating that it is for Medicare Part B
–Ohio PERS
So, I do not need to include a cancelled check for the quarterly payment?
Lucy,
That is what we have been told.
–Ohio PERS
Thanks!
One Exchange is not telling the truth if they are telling you that you do not need a cancelled check for the quarterly payment. Have been fighting this issue with them since January and every quarter I have to go to my bank (they do not return cancelled checks) and have them print me a statement showing my check to medicare has cleared and fax that statement, my invoice from medicare, and a reimbursement form from One Exchange. I already tried the “recurring reimbursement claim form” and One Exchange refused to accept that. Also I tried again just last week to see if anything had changed so I could stop pestering my bank and they said nothing could be done-still have to go thru this process every quarter. They are a pain to deal with.
Daisy,
We have forwarded your questions to our dedicated account team at OneExchange to research. They will call you within 48 hours.
–Ohio PERS
The last time I was on the phone with One Exchange the total phone time was 2 hr and 45 min. Nothing was resolved. I had started calling in February. Were any of these people vetted?
Something is drastically wrong with your Reimbursement video. I submitted a Recurring Medicare Part B
Reimbursement form the Social Security Verification Letter for my wife. The verification letter was exactly
the same as the one you had in your video except it had my wife’s name and her amounts with the current date of 2016. The first time it was denied my 2016 date were change to 2015 on the denial letter.
I resubmitted it again with the verification letter from Social Security and once again it was denied. I called OneExchange and they told me the verification isn’t good. I called OPERS they said they could not help me because the verification letter isn’t valid proof. I talk with other people and was told their verification letters were valid. What do I have to do?
Richard,
We do not process these claims — that’s what OneExchange does. Our records do not indicate that we told you the verification letter isn’t proof. Clearly, it is, but it has to be dated correctly. You state that OneExchange said “the verification isn’t good.” Why? We recommend calling them again and asking them to specify what you need to do differntly.
–Ohio PERS
The Date on the letter was dated March 09, 2016 from Social Security. I don’t see the problem with the date. Everyone else that has sent in the letter has the same format with the exception of the date of the letter. They have a date that is much earlier.
Rich
I did all of that and I have to do it again no one can find where I sent in the information.
We sent a claim form to One Exchange two months ago for Medicare Part B reimbursement and have never received any reimbursement
I have had nothing but trouble trying to get Medicare B premium reimbursement. I do not receive social security so I have no benefits letter. Medicare B is taken from my checking account. I sent a recurring reimbursement form which was denied. I was told by one exchange without a benefit letter you cannot get recurring reimbursement that I had to submit each month separate. I submitted Jan and Feb with the documentation and Jan was reimbursed but Feb. denied. I resubmitted Feb two months ago and have heard nothing. If you talk to three people at one exchange you get three different instructions. No one at OPERS will deal with this they just say call one exchange.
Rich,
We have asked OneExchange to contact you about your Medicare Part B premium reimbursement.
–Ohio PERS
Thanks
I agree with Richard Donelan every time I am lucky enough to talk to an OneExchange Rep. I get different info on how or what to do to get a claim reimbursed, except the recurring medical premium or Rx’s. I had a large dental claim in April and it was denied. ($656.50) There would not have been enough money in my account to cover it and pay other reimbursements, I have every month. I get that, but I had a small dental claim in April and it was denied ($30.00) I faxed all of the paperwork necessary to back-up claim.
As far as Medicare Part B premium. I filed it the same way in Feb. and May. It was paid in Feb. and denied in May.
What is going on with OneExchange powered by Towers Watson?
As for your statement Michael Pramik about OPERS not paying the claims, that is what OneExchange does. Well, if OneExchange is paid with money from the OPERS funds, someone at OPERS better start listening to complaints and doing something about it. I am 67 and I am computer literate because of the job I had, when I worked for Butler County. I feel for the older people that are trying to deal with this mess. I have friends that have retired and are in the OPERS system that have not even tried getting any reimbursements because they don’t know how to!
Faye,
We have listened, and we are working with OneExchange to improve its service. You should have gotten a letter from us a couple of months ago detailing the lengths we have taken to make sure OneExchange provides acceptable customer service.
–Ohio PERS
I did get the letter!
I totally agree with the other comments about being reimbursed for Medicare B thru One Exchange. I have had nothing but trouble with them on this. I also was told different things by each person I talked to. I finally gave up on the automatic reimbursement and from now on I will simple send a cashier check to Medicare for payment so I will have a hard copy to send to One Exchange. I pay quarterly and so far I have had to go to my bank and have them print me out a copy of proof that my personal check was indeed paid to Medicare and the amount paid, along with my bill showing the exact from Medicare. I do not receive my personal checks back nor does the bank and when you send a personal check to Medicare it is treated as a “preauthorized debt” so I had no proof of payment. It has been a pure mess to get reimbursed for Medicare. This will be the first time I try the cashier’s check so I’ll see how this works. One Exchange is a pain to work with.
While I have been skeptical of this new system so far One Exchange has come through for my husband and myself. There have been several problems that require me to call and ask what is happening. The one thing that pleased me very much is that the first person I talked to stayed on the line while I talked to a second person. So I was able to have both ladies answering my questions at the same time. I have had some of my paper work returned because I faxed it to the wrong fax number in their system. I have found mailing and faxing, so far, works better than their on line process of submitting information.
I totally understand people’s frustration i have had three hour phone calls with other company services. It is very trying to get someone to listen or at least explain what needs to be completed to obtain the service.
I do believe One Exchange services will improve, however, as someone mentioned above it will take a year or two with problems still arising because we are dealing with human and computer errors. Hope all have a great summer.
Spoke with OE rep today. They will NOT pay quarterly recurring Part B premiums on a quarterly basis…meaning, I write a check to Medicare in December to pay premiums for Jan, February and March. OE will only reimburse me on a monthly basis. So, I pay full amount in December and they reimburse this December paid amount in three equal installments over a three month period of time.
Lucy,
You’re correct that OneExchange does recurring reimbursements only on a monthly basis. You can get all the money at once if you file manual reimbursements every quarter.
–Ohio PERS
I have called, One Exchange about reimbursement for Medicare. They keep on reimbursing me for 104.90 , instead of 73.09. I am now owning money . My husband Paul, is also going through the same problem. We both retired from OPERS. Please help us. Thank You
Barbara,
Thanks for bringing that to our attention. We’ll forward your comment to OneExchange.
–Ohio PERS
I called One Exchange…I have never received any Bill or notification about Medicare part B. One Exchange told the difference would be automatically deducted from me S.S. check….nope, hasn’t happened…now what do I do ???? Your tutorials don’t make sense most of the time, I have seen nothing about Medicare part b…..there has never been a seminar close enough for me to attend without driving an hour or more !!!!!!!
We all need help and more accountability. Calling one exchange is tedious and time consuming.
Barbara,
If you’ve never received a bill for Medicare Part B, you need to start with the Centers for Medicare & Medicaid Services. Call 1-800-MEDICARE.
We also have a webinar for transitioning to the Connector, as well as many recorded presentations on the Education portion of our website.
–Ohio PERS
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Could you please post the most recent and up to date details on getting Medicare B reimbursements from One Exchange. I have seen and read so many different ways it should be done. I just want to find out the absolute, most accurate information for people who pay quarterly and don’t receive social security. I really need help with this matter.
B.,
Here it is. There are a blog and a video to help you.
–Ohio PERS
The process of retiring has never been fully explained and they fail to inform what we can do on partB funds.I now recieve my humana refunds in my bank every month.My insuance from Medical Mutual takes 3 or 4 months. Why?
I’d like to be able to help clarify, but need more information. To best serve your needs, please call OPERS at 1-800-222-7377 to speak with an OPERS representative. We would very much like to help clarify further.
-Ohio PERS
I do not receive social security so my Med Part A is payable by me. Is this expense reimbursable from my HRA account in the same manner as Med Part B? I am currently reemployed, so at the moment I do receive reimbursement through my pension, but, just wondered how that might be handled when I am no longer employed and start to receive an HRA account.
Nancy,
We need to review your account to give you a full response. Please call us at 1-800-222-7377 and a member of our staff can help you.
Julie, OPERS
Where is the form to request reimbursement for Medicare premiums?
Please forward your questions through your OPERS online account message center or contact OPERS at 800-222-7377.