Essie contacted me Thursday looking for help with an $800 balance bill from a $33,000 surgery last March. Since their coverage is subject to a $1,000 deductible plus 80/20 coinsurance, that didn’t seem unreasonable.

Then came the surprise.

When Essie turned 65 – two years ago – she bought an individual Medicare Advantage Plan, reasoning it costs practically nothing and the duplicate coverage would fill in any gaps from the group plan.

Pretty sure the agent (1.) selling the Medicare Advantage Plan would know with a group plan in force, that’s not permissible.

Alternatively, Edward (2.) should have told his HR department to drop his wife.

Could the HR Manager (3.) have affirmed Edward’s spousal election when Essie turned 65?

Last, maybe the group’s agent (4, and that’s ME!) could have alerted HR of anyone reaching Medicare eligibility.

Back to Essie.

Forget about that $800 plus, you’re out $4,147 of wasted premium

Not to mention our client needlessly spent $16,589.

Woulda. Shoulda. Coulda.

Dads and accountants hate those words!