Can an individual be reimbursed for the premiums they paid to a supplemental insurance carrier when they were not needed?

Like most of us, you seem to be confused about Medicaid and Medicare. Medicaid is for people who need medical (including nursing home) assistance due to few "countable" assets (which do not include the home) and low income. Medicare is for disabled people and people 65 and up. It comes in two flavors: Medicare Advantage (formerly called, "Medicare Choice") and traditional Medicare. Traditional Medicare includes hospital coverage (Part A), out of hospital coverage (Part B), prescription drugs (Part D) and the opportunity to buy supplemental or "Medigap" coverage. There are about a dozen forms of this. Perhaps your mother's BCBS supplemental insurance is her Medigap policy.

In any event, the likelihood of an insurance policy returning premiums because the insured later discovered that she was over-insured is slim to nil. She bought the insurance and the insurance company insured her, whether or not she ever applied for benefits.

I'm sorry to say NikkiP in My opinion Your Mom would have a far greater chance of finding the crock of gold at the End of the Rainbow.
Insurance Companies do not entertain reimbursements.

Nikki - my mom had BCBS as her secondary to Medicare for years; when she went onto NH Medicaid, she had BCBS policy "suspended" with payback of premiums paid for the 6 mo period she was "Medicaid Pending". BCBS like most insurers will not pay for services IF there is another insurer who can be billed either as primary or secondary. Medicaid & Medicare are primary or secondary insurers depending on what the ICD-10 code is.

There was an upside & a downside with this at least for my mom.

Her BCBS was high option federal (policy through my deceased dad) w/premiums taken from federal annuity automatically each mo. Premium was very low (a federal perk!). TX Medicaid pending took almost 6 mos to process, so during that period many services provided at NH & an ER visit were billed to & paid by BCBS. Once she became Medicaid eligible, BCBS can either become "suspended" or cancelled. Mom did suspension. So this made her Medicaid required co-pay or SOC (share of cost) of income paid each month to the NH higher once the suspension in place at month 6. Now in speaking with her caseworker at month 4 or 5 on a snafu on her life insurance policy clarification, he told me to try to make it so that the month she got the 6 mo premium $ back to have her assets under 2K with the added in premium $, otherwise she'd be over Medicaid asset limit & it would need to be reported. The back pay premium was NOT owed to NH as long as her overall financial eligibility was within Medicaid limits. $ back was just a few hundred.

But one problem that arose and went on for months & month & months was that vendors who were paid by BCBS had their payments clawed back. Or if they continued to bill BCBS had their invoices rejected. If they wanted to be paid, they had to rebill to Medicaid. Medicaid pays lots, lots LOTS less than BCBS. I sent a certified letter to NH on the BCBS suspension at month 6 when filed & received by BCBS. NH as they - via the medical director or DON - contact & contract vendors have the responsibility to let them know. Long story short…vendors not happy. Couple did NOT participate in Medicaid, so no rebilling done but payment claw backed. Clawbacks do not happen quickly plus many vendors have so much billing back & forth not noticed right away. One PT billed my mom at month 9; others well over a year later. Problem is that if they are on NH Medicaid, they have no real $ to pay bills in full. One of the PT's was willing to be paid partially discounted from the BCBS premium overage. Another just wouldn't & went off at a care plan meeting on this & not happy with either myself or NH (as NH DON didn't tell vendors). Another sent bills for over 2 years & again would not take partial payments.

My point is that IF your mom had any services paid by BCBS for all those years and you/mom file to get all that $ paid to BCBS, BCBS will clawback and vendors can bill your mom or if you signed off to be financial responsible for her seek you out to get paid; file collection.

Also if your mom were to get all those years(?) of payments back, it probably would not be smallish $ like my mom's was. But have a comma in it - 1 year alone is $ 2,100 much less 10 or 12 years!!! - so your mom would be ineligible for Medicaid, possibly for months and a whole stack of paperwork to wade through plus probably have to reimburse the state for care provided or do a spend-down. 10 years = $ 21,000.

Let it be. She & you totally own the error, you all's mistake. Doing anything now becomes a total clusterF of problems imo.

Was ur Mom given Medicare because of a disability before 65? If so then this is why she is receiving Medicaid. If she received Medicaid after 65 then she applied for it and should have dropped her other insurance at the time she qualified. You cannot blame the insurance company. Somehow they found out ur Mom was now on Medicaid and did send a notice. It was up to ur Mom or her representative to cancel this policy. The blame is not the insurance companys.

I spoke with a social worker at Tricare and she said it was the patient's responsibility to know their options and a person can always purchase another type of insurance policy.

I'm not sure if it would be applicable here; but in the US have you had the same kind of scandal and backlash against "mis-selling" of financial products that we've had in the UK? I'm just wondering if NikkiP's mother might make some headway if she were able to establish that the insurer was at fault for selling her a product that was inappropriate for her.

No, it's not likely at all you will get back a single cent.
Dad bought a LTC policy for mother, so she would not have to be a burden to us kids ( as he felt he was). It will never be used and we know we can't get back the cost of the policy. It's like buying car insurance and you don't drive. Ins companies don't care--if you bought the policy, you "HOPE" you won't need it, but it's insurance against the unforeseeable. Because you didn't need it, or use it, that's great for them. It's like a bet: You bet you'll need the insurance, and the ins co bets you won't. They win, always. Why are they so huge and make so much money?? You can try, but, don't have any hopes hinged on getting anything back.

When my aunt went into a nursing home she finally ran out of money and had to go on Medicade I continued to pay her supplemental insurance. She was given a special low rate for RX policy. She was able to keep $40.00 a month and under $2000.00 in checking account. Medicade paid nursing home bill after her account gave them what was left of SS monthly. This is in Ohio. I wouldn't dream of not paying her premium. It saved the state her medical bills. In the end she could only keep 40.00 anyway. I'm just greatful that she was cared for. Absolutely no complaints.

My father-in-law retired and his medical insurance premiums were being deducted from his pension. He had difficulty understanding business/medical terminology and after approximately 15 years, told me his insurance had been cancelled. I poked around, discovered that not only was his insurance still in effect, but he had also been paying premiums for his deceased wife. I contacted the insurance. Per their request I provided a death certificate and explanatory letter. He received a huge refund for over 10 years of premiums on his wife. It never hurts to contact the insurance company. Different circumstances will have different answers.

Nikki, if you're still around 6 days later, I believe it would be considered that your mother initiated and continued the BCBS coverage of her own free will, that she was not coerced, and could have realized she didn't need it by doing some research.

This is not a criticism, just the factual way it would be viewed.

It's incumbent on each of us to do the necessary research and make our own decisions as to whether to carry supplement or gap insurance.

And in my experience, if premiums aren't paid after I believe it's 2 months, BCBS stops coverage; in any event, it wouldn't pay for any of its portion of costs incurred during that period.

That raises another issue; BCBS could state that, if it did pay anything during the period of coverage, it would have the right to recover those payments.

This is a sad situation, and it's kind of you to share it; people can always see this a situation that they should avoid.