NORTH ATTLEBORO, Mass. (WPRI) – Heath Hobson didn’t need any outside motivation to return to the workforce after shrapnel nearly took his life in Iraq almost a decade ago, but his drive to get off permanent disability revealed an apparent crack in the healthcare system that he was told would cover him for life.
“The frustrating part is that no one is willing to look deeper into it and do anything about it,” Hobson said. “It’s pretty much, take it on the chin.”
It was January 2007, just outside Baghdad. Sergeant Hobson had just returned from an Operation Iraqi Freedom mission, as part of the 101st Army National Guard.
“And almost exactly at 4 p.m., we got attacked by rockets,” Hobson recalled. “A big piece of shrapnel just took me right out. Severed my right leg in half.”
Surgeons saved his life and his leg. After 17 operations, some lasting 10 hours, Hobson was back on his feet, designated as medically retired and promised the military healthcare program, Tricare Prime. That meant no premiums, no co-payments and what Hobson would call “great coverage.”
“The army said to me, ‘Hey, you’re a retiree. You get this for the rest of your life,'” he recalled.
While he was recovering at Walter Reed Army Medical Center, Hobson was approached by the Social Security Administration and was soon receiving Social Security disability benefits. SSDI came with healthcare coverage from Medicare Part A and Medicare Part B, the second of which involved a small premium.
Hobson said SSDI and Medicare made sense at the time, but he also points out he never asked to be a part of either program.
“And I never intended to stay on it,” Hobson said. “The way I looked at it, it’s just a leg. My brain works. My hands work. Staying home on the couch just isn’t me.”
He enrolled at the University of Massachusetts Boston in September 2009 and graduated in December 2011. By the following April he was working full-time as Mansfield’s veterans services officer, a post he held until he became program coordinator for the Massachusetts Rehabilitation Commission.
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Ironically, Hobson’s job is to help veterans secure their various benefits – but shortly after rejoining the workforce he discovered how difficult it would be to help himself.
Hobson said he checked with multiple federal agencies, including the Army and the Social Security Administration, and was told the same thing about paying the premium for Medicare Part B.
“They were saying, just don’t pay your Medicare and you should be all set,” Hobson said. “Tricare should pick you back up.”
But it didn’t.
Around 2013, he was getting billed for procedures he thought were covered.
“And I thought it was just a discrepancy, a mistake that they were sending me bills,” Hobson said. “And so did everyone else from the federal agencies I was dealing with. I never got the proper direction on what to do.”
As he dug deeper into what happened, he found out not many SSDI recipients leave the program.
“I was told 0.02 percent of anyone on disability ever returns to the workforce,” Hobson said. “That being said, I’d say it was extremely rare.”
He said he also found out something else no one told him. On the rare occasions when someone does return to work from permanent disability, they cannot withdraw from Medicare Part A for 93 months.
That is part of the Ticket to Work legislation that was put on the books in 2000 as an incentive to return to the workforce.
“I didn’t need an incentive. All the representatives I spoke with said that I should be able to withdraw from Medicare and get back on Tricare,” Hobson said. “They were wrong.”
So now he is faced with what is truly an example of a Hobson’s choice.
The first option: wait until next January to enroll again in Medicare Part B, which will mean paying a penalty and premiums that Hobson said will add up to about $11,000 by the time he’s eligible for Tricare in 2020, after that 93-month period ends.
The alternative: continue with partial coverage and keep fighting for what he was promised – full coverage, no premiums, no co-payments.
“I was told I’d have Tricare for the rest of my life,” Hobson said. “My wife and kids are on Tricare Standard, under me.”
He emphasized one detail with an almost incredulous tone.
“They are under me,” Hobson said. “I’m the sponsor, and I can’t get on it.”
Steve Richardson, the Social Security Administration’s regional communications director, said he will make sure a local agent looks into Hobson’s situation, adding that this is also an issue that clearly involves the Veterans Administration.
“In a situation like this, you need to be very clear with the VA. Do I need Part A and Part B?” Richardson said. “We can’t stress that enough. But I don’t speak for the VA and I will make sure we do everything we can to help in this case.”
Emails requesting comment from Tricare have not been returned yet.
As for Hobson, he is just hoping his case will help others avoid what has been a three-year struggle.