The fight over Obamacare is over — for now. What does that mean for seniors?
Editor’s Note: Journalist Philip Moeller is here to provide the answers you need on aging and retirement. His weekly column, “Ask Phil,” aims to help older Americans and their families by answering their health care and financial questions. Phil is the author of the new book, “Get What’s Yours for Medicare,” and co-author of “Get What’s Yours: The Revised Secrets to Maxing Out Your Social Security.” Send your questions to Phil.
Andy Slavitt, the acting head of the Centers for Medicare & Medicaid Services at the end of the Obama administration, has been a tireless opponent of Republican efforts to repeal his former boss’ signature health care law. Last week, after three Republican senators voted against approving the so-called “skinny” repeal bill, Slavitt tweeted that he would be taking a weeklong break from the social media platform.
One commenter on this news said, “I will believe this when I see it.” That was his wife, Lana.
Medical, senior and health care research groups overwhelmingly opposed the various bills that the Senate hatched — in secret and with virtually no public debate. They, too, are looking for some relaxation in August. But Congress will be back in session in September, so these groups will be recharging their batteries.
They also will be nervously checking President Donald Trump’s tweets, which so far have indicated he will do whatever he can to help Obamacare fail and thus force Congress to act. And don’t forget that the Senate will still be in session for two more weeks and that Trump has launched a shame-and-threaten offensive to get Republican senators to take up health care before they go home. To date, there seems little chance Republicans will take up health care again any time soon.
However, Republicans are far from finished when it comes to trying to honor their seven-year-old pledge to do away with the Affordable Care Act. And don’t forget that the Affordable Care Act provides major financial benefits to Medicare, as well as reducing the share of drug prices that Part D plan holders must pay. Even if direct repeal is off the table for now, you can expect some Republicans to seek to damage the law by using some of the other powerful tools at their disposal.
Further, the federal budget proposed by the Trump White House includes direct cuts to senior safety-net programs. There also will be continued GOP efforts to give the states significant control over how Medicare and Medicaid funds are spent. Current federal guarantees of payment for covered health expenses would be replaced with block grant programs giving states a say over how much such expenses would be covered and, in time, even whether some expenses would be covered.
Today, with Capitol Hill’s largely silent and long-postponed summer vacations underway, there is little appetite for re-engaging in nasty policy fights. But when the leaders and their troops are rested, there is little doubt that we will be back at it again. For the time being at least, enjoy your beach reading and favorite libations! And now, because reader questions never take a vacation, here are this week’s answers.
Anonymous – N.Y.: My wife is 72, but because I’m still working, she’s on my corporate health plan. Of course, our deductible is sky high at $4,000 a year. We put the maximum into our health savings account, $6,500, and the company puts in $2,000. She’s healthy, but has gone into the emergency room twice this year for a stomach issue.
The first bill included $200 for the ER copay, $109 for a CAT scan and $758 for the doctor’s fee. What really hurts is that doctor’s fee! The doctor who saw her was out of network (and of course, we have no visibility into this or choice about it). I’ve not yet received the bill for the second visit, but we’re afraid this might be something that happens more often going forward.
If it’s going to cost about $1,000 for an ER visit, does it make sense for her to get Medicare Part B? It seems like two visits to the ER would pay for the yearly premium and then some. What do you think?
Phil Moeller: You need to do the math, but I agree that Medicare deserves a close look as a preferred alternative to a high-deductible employer plan. I’m assuming here that your family’s overall medical bills would fall short of hitting your deductible. Otherwise, you might still be better off on the corporate plan, because at least your out-of-pocket maximum would protect you.
Kit-Marie – California: I am 66 and plan to wait until 70 to begin my own Social Security retirement benefits. I would like to file a restricted application and receive only divorced spousal benefits right now. I was married to my ex for more than 10 years, and he has remarried. I have not. I am concerned and anxious that somehow my own retirement benefits will get triggered when I file for a spousal benefit.
The Social Security person I spoke with on the phone said all the benefit application forms are the same. He said that I should write out what I want to do in the information area of the application’s “Remarks” box and that would get channeled to the proper place. There was no mention of a restricted application. Do they in fact have an actual form labeled restricted application?
Phil Moeller: As far as I know, there is no specific form for a restricted application. And I have heard from other readers that their Social Security office and representative were not informed about filing a restricted application. So you are right to be cautious. If it helps, here is Social Security’s own explanation of the right of someone your age to file a restricted application.
The representative is correct that it’s important to provide a precise description of your restricted filing in the remarks section of the application. I don’t know if there’s any magic to the wording. I would say something like: “I wish to file a restricted application for my ex-spousal benefit and defer filing for my own retirement benefit.”
I think the best way to proceed is to make an appointment at a local Social Security office and file for this benefit in person.
Mary Ann – Florida: My mother is 81. She has supplemental prescription drug insurance. Her premiums are high and keep going up, because they told her she had to pay late-enrollment penalties. How can she have late enrollment penalties at 81? She’s been on Medicare since before she was 65 for disability.
If the late enrollment has to do with not applying for drug insurance on time, then why is she still being assessed for late enrollment penalties after the first year? Something doesn’t seem right.
Phil Moeller: Unfortunately, Medicare’s Part D drug plans have their own late-enrollment penalties separate from those involving basic Medicare. Adding injury to insult, these are lifetime penalties that will be charged to her forever.
If your mom’s income is low enough, she might qualify for Medicare programs that subsidize both Medicare and Part D expenses. The State Health Insurance Assistance Program provides free Medicare counseling. Perhaps someone there can help you sort through these programs to see if your mom qualifies.
James: I am now 64. When Social Security’s 2018 cost of living adjustment (COLA) takes effect, will it increase the amount I will get at age 66 if I retire then? Also, my wife is 53 and may be going on disability for health reasons. Can I claim a spousal benefit at 66 and still let my Social Security keep growing?
Phil Moeller: Annual Social Security COLAs raise the benefit levels — at least in nominal dollars — of both current and future Social Security recipients. The COLA is designed to maintain the real, or inflation-adjusted, value of Social Security benefits. It should have no effect on your decision about when to begin taking benefits.
If you turned 62 before Jan. 2, 2016, you are grandfathered in under new Social Security laws enacted in late 2015. As such, you may file a restricted application for a spousal benefit when you turn 66 and defer your own retirement filing until as late as age 70, when it will reach its maximum level.
Lydia – New York: I am 56, disabled and on Social Security disability and Medicare. My boyfriend is 59 and took early retirement. His employer will provide him health insurance until he qualifies for Medicare. Will I lose my Medicare if we marry before he goes on Social Security and Medicare?
Phil Moeller: Please rest easy! You won’t lose your Medicare, regardless of your marital situation. This is your coverage and is not connected to his. In most cases like your boyfriend’s, his former employer’s plan would only apply to him and would not even be a family plan. But if his plan did allow you to be covered, that would be your choice and not a requirement.