Medicare

Q&A: Medicare vs. spouse’s health plan

October 28, 2019 By Liz Weston

Dear Liz: I am planning to retire in a few months at 65. My husband, who is five years younger, works for a corporation that provides excellent health insurance. When I sign up for Medicare, will I still be able to stay on my husband’s health insurance? Which insurance will be listed first for coverage?

Answer: The rules are different depending on whether your husband’s insurance is considered a large employer plan or a small employer plan.

If the plan covers 20 or fewer employees, his employer can boot you off the plan or make it secondary to Medicare. If the plan covers more than 20 employees, though, the employer typically can’t treat you differently from younger employees and spouses and must allow you to stay on the plan, which would remain your primary insurance with Medicare as the secondary insurer.

Medicare penalties are another issue to consider. Medicare Part A, which covers hospital visits, is usually premium-free, but people generally pay premiums for Medicare Part B, which covers doctor’s visits, and Medicare Part D, which covers prescription drugs. If you don’t sign up for Medicare Part B and Part D when you’re first eligible, you could face permanent penalties that would raise your monthly premiums for life.

These penalties don’t apply if you put off signing up for Part B and Part D because you’re covered by a large employer health insurance plan from current employment, either yours or your spouse’s. Once that employment or coverage ends, though, you’ll need to sign up for Part B and Part D promptly or the penalties kick in.

Notice the use of the words “typically,” “normally” and “generally” in the paragraphs above. Medicare’s rules and exceptions can be tricky to navigate. Talk to the benefits manager at your husband’s company so you know where you stand, and what parts of Medicare to sign up for as you turn 65.

Wednesday’s need-to-know money news

October 9, 2019 By Liz Weston

Today’s top story: Understanding the differences between Medicare and Medicaid. Also in the news: How hungry college students can get help, Robinhood takes another shot at cash management accounts, and a new scam that asks for your bank PIN on the phone.

Hunger on Campus: How College Students Can Get Help

What Is the Difference Between Medicare and Medicaid?
Understanding the government-run health care plans.

Robinhood Takes Another Shot at Cash Management Accounts
This time with FDIC backup.

Beware a New Scam That Asks for Your Bank PIN on the Phone
This is a particularly savvy scam.

Q&A: Medicare has a prerequisite

September 30, 2019 By Liz Weston

Dear Liz: In a recent column, you mentioned that Medicare Part A is free, but that requires 40 quarters (or 10 years) of U.S. employment to qualify. There are, unfortunately, many of us with offshore employment who have found this out too late. Even if one has worked in a country with a tax treaty with the U.S. that allows you to transfer pension credits to Social Security, that will not allow you to qualify for Medicare. I think it would have been very helpful if I had known this about 10 years ago!

Answer: Medicare is typically premium-free, because the vast majority of people who get Medicare Part A either worked long enough to accrue the necessary quarters or have a spouse or ex-spouse who did. (Similar to Social Security, the marriage must have lasted at least 10 years for divorced spouses to have access to Medicare based on an ex-spouse’s record.)

But of course there are exceptions, and you’re one of them. People who don’t accrue the necessary quarters typically can pay premiums to get Part A coverage if they are age 65 or older and a citizen or permanent resident of the United States. The standard monthly premium for Part A is $437 for people who paid Medicare taxes for less than 30 quarters and $240 for those with 30 to 39 quarters.

Q&A: Avoiding Medicare sign-up penalties

September 16, 2019 By Liz Weston

Dear Liz: Someone recently asked you if signing up for Medicare is mandatory. Your answer implied no, one does not have to sign up at 65. However, it is my understanding that if a person does not enroll when first eligible, they will be hit with large penalties on their Medicare premiums if they sign up later. Am I missing something?

Answer: Not at all. That answer was too short and should have mentioned the potentially large, permanent penalties most people face if they fail to sign up for Medicare Part B and Part D on time.

To review: Medicare is the government-run healthcare system for people 65 and older. Part A, which covers hospital care, is free. Medicare Part B, which covers doctor’s visits, and Part D, which covers prescriptions, typically require people to pay premiums. Many people also buy Medigap policies to cover what Medicare doesn’t, or opt for Medicare Part C. Part C, also known as Medicare Advantage, is an all-in-one option that includes everything covered by Part A and Part B and may include other benefits.

There’s a seven-month initial enrollment period that includes the month you turn 65 as well as the three months before and three months after.

People who don’t sign up when they’re first eligible for Part B usually face a penalty that increases their monthly cost by 10% of the standard premium for each full 12-month period they delay. For Part D, the penalty is 1% of the “national base beneficiary premium” ($33.19 in 2019) times the number of full months the person was uncovered.

People who fail to enroll on time also could be stuck without insurance for several months because they may have to wait until the general enrollment period (Jan. 1 to March 31) to enroll.

People typically can avoid these penalties if they have qualifying healthcare coverage through a union or an employer (their own or a spouse’s). When that coverage ends, though, they must sign up within eight months or face the penalties. Also, they might not avoid the penalties if their employer-provided coverage becomes secondary to Medicare at 65, which can happen if the company employs fewer than 20 workers. Anyone counting on union or employer coverage to avoid penalties should check with the company’s human resources department and with Medicare to make sure they’re covered.

The original letter writer had no income to pay Medicare premiums, so the answer also should have included the information that Medicaid — the government healthcare program for the poor — might help pay the premiums. People in this situation should contact the Medicaid office in their state. (Medicaid is known as Medi-Cal in California.)

Thursday’s need-to-know money news

June 13, 2019 By Liz Weston

Today’s top story: What will long-term care cost you? Also in the news: Social Security myths, the best cities for first-time home buyers, and how to pay less to your credit card company.

What Will Long-Term Care Cost You?
Almost everyone will need it after 65.

Don’t Believe These Social Security Myths
Checking the facts.

These are the best cities for first-time home buyers
7 spots to look at.

Here’s how to pay less to your credit card company
Just pick up the phone.