Can anyone help me out?

Where to begin?  Back in 2006, my mom was in an accident and was deemed partially disabled.  She was eligible to receive Medicare Part A and B.  Because my dad was a retired state employee with full benefits, she declined (thinking she was covered enough under my dad's policy).  She was told she would automatically be covered under Part A whether she declined it or not, but that she would not be under Part B unless she paid to be enrolled in it, which she declined.  My mom continued to see her regular doctors and gave them her Medicare Part A card.  Because Part A only covers hospital bills, the doctor's offices never did anything with it -- didn't bill for her office visits through that or anything, just through my dad's policy.

In January of 2008, she was recommended to have a hysto.  The nurse in the office called and got authorization for the surgery and hospital stay.  For the first time ever, her Part A was billed for the hospital bill.  This set off a nightmare of events.  When my dad's policy found out she was covered under Part A, they sent her a letter stating that she was no longer covered under my dad's policy.  After much researching through my dad's retirement benefits packet, they found out that if at anytime a dependent became eligible for Medicare, they had to enroll in Part A and B -- no choice.  My parents were not aware of this and she did not enroll.  Now my dad's policy is retro'ing the termination back to the date that she was eligible to enroll in Part B and didn't.  She just got $23,000 worth of insurance claims that are being denied, stating that she was not covered at the time of service.  Her doctors will now be billing her for these services.  The insurance took these claims back to the 2006 date that she was eligible.

Does anyone know if they can do this?  My mom did not intentionally try to keep this a secret.  She honestly didn't know she had to enroll in Part B.  Even when she was told by Medicare that she had Part B available to her, no one told her that she should check with my dad's insurance to make sure she wasn't required to enroll.  In fact, the one person she spoke with said "If you're covered under his policy, then I wouldn't worry about it." 

Now my mom is a nervous wreck and she's asking me for help, but I don't have a clue.  Just because I work in the medical field doesn't mean I know about these kinds of things.  I didn't know either that she had to enroll.  It just seems to me that the insurance shouldn't be allowed to go back that far to readjust these claims.  I thought there was a time limit on that stuff.  She's already spoken to her local congress rep (since my dad was a state employee) as well as the current union representative from my dad's previous work place.  No one is willing to help and I don't know what to tell them.  My mom expects me to have answers and I don't.  Has anyone else ever gone through this or know of anyone that can help their situation.  We live in PA.

• Can anyone help me out? - at my wits end
  • Information on coverage - Finding out
  • I would call the Insurance Board in your state.........sm - m
    • Thank you so much -- - at my wits end

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