Posted on Friday, 7th February 2025 by

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Since writing the article “Medicare Prescription Drug Plan Fiasco – The Continuing Saga,” I’ve received over 40 emails and comments from site visitors experiencing the same issues; several are paying considerably more for their prescriptions under the MPDP plan. You can review all of the comments on our blog, they follow the article mentioned above.

This started last November, and many are still waiting for a resolution. We received letters from Social Security last Wednesday stating, “We will no longer deduct your prescription drug coverage income-relate monthly adjustment amount from your monthly benefit.” They are refunding the penalty and Part D premiums we paid in January this month.

Our Medicare online accounts also show that my wife and I do not have a Part D premium being deducted from our Social Security checks.

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What Caused the Problem?

From my discussions with multiple sources, GEHA enrolled all Medicare-eligible members in the MPDP program even though members initially had until early December to opt out of the program. This caused mass confusion for those wishing to remain with GEHA’s prescription drug coverage, and this triggered actions by Social Security and Medicare to enroll us in Part D.

Many of us filed appeals with Social Security and OPM’s OIG and contacted our representatives. Hopefully, this won’t create more issues as these entities go back and forth between OPM, Medicare, and Social Security.

Initial Contacts and Actions Taken

When I first became aware of the problem, I submitted an appeal to Social Security and, shortly thereafter, filed a complaint with OPM’s OIG. If your issue hasn’t been resolved, use the OIG’s online complaint form to file a complaint regarding fraud, waste, abuse, or mismanagement within OPM’s programs and operations.

The complaint form is the preferred method for submitting a complaint; however, you may also submit your complaint by calling the OPM OIG Hotline Number: 1-877-499-7295.

I also submitted this issue to my senator and Congressman. If you don’t need to register a complaint with them now, write down your representative’s contact information if you need assistance. We elected them, and they are one of our first lines of defense when we have an issue with a federal agency.

GEHA Response or Lack Thereof

My first call was to GEHA, and they forwarded me to one of their prescription drug customer service representatives. As I explained in my first article, they didn’t offer a resolution other than to call Silver Script again.

Medicare’s website showed that my wife and I were scheduled to pay a Medicare Part D premium through December 2025, and Social Security advised us that we had to pay a penalty plus late payment fees for Part D that we didn’t have.

After numerous calls to GEHA without resolution, I requested that GEHA’s public relations office set up an interview with the person responsible for their MPDP option and the opt-out process. They didn’t reply to my email request.

I made one final call to GEHA’s prescription drug customer service representative last week, and she was very helpful and empathetic. She has talked with hundreds in the same situation and assured me that all would be taken care of shortly.

Summary

I intended to write a follow-up article after my wife’s Social Security check arrives on the second Tuesday in February. Many people had asked for an update, so I thought it best to send one out as soon as possible.

It appears that our Part D premium has been canceled. We should know soon if they caught it in time for this February’s checks. Plus, Social Security has to send out a change notice since they notified us on January 3 and again on the 6th that we were enrolled in Medicare Part D and they were withholding premiums and late penalties from our checks.

I really don’t know why mine got changed back to where it should have been from day one. We haven’t received feedback from any of those we contacted.

If your Medicare account still shows Social Security will be withholding Part D premiums, and you opted out of their MPDP program, you may wish to file a complaint with OPM’s OIG and go the same route I did. Possibly make one more call to GEHA; hopefully, you will reach the same very pleasant representative I talked with last week.

Many suggested moving to another provider during the next open season. I’m staying with GEHA, and as I stated in the previous article, they have provided exceptional healthcare services at reasonable costs over the past 11 years.

Hopefully, whoever was responsible for this fiasco is no longer with the company.  Plus, most other FEHB providers already offer MPDPs; you may have the same issues if you change to another company next open season.

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Disclaimer: The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, investment, and benefit information are subject to change. To ensure the accuracy of this information, contact relevant parties for assistance including OPM’s retirement center.

Over time, various dynamic economic factors relied upon as a basis for this article may change. The information contained herein should not be considered investment advice and may not be suitable for your situation. This service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Last 5 posts by Dennis Damp

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