John and Mary Benbow, 67, and 68, respectively, of La Jolla, shown holding his finger over his social security number on h...

Column: Questionable Social Security and Medicare policies put seniors in a bind

Editor’s Note: Journalist Philip Moeller, who writes widely on aging and retirement, is here to provide the answers you need in “Ask Phil.” 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.

Social Security announced last week that its annual cost of living adjustment, or COLA, for 2017 would be a paltry three-tenths of 1 percent. As I explained then, this small increase is unfair to Social Security recipients and will also trigger an absolute mess with Part B Medicare premiums for the second straight year.

READ MORE: Average senior’s Social Security check to increase a measly $4 in 2017

Melinda, from California, wrote me a heartfelt rant and lament about this situation. Because it channels what I think many older Americans are thinking, I want to share it with you and ask you to share it with others, including the you-know-whos in Washington. Melinda asks me in her note about my views of what should be done about this situation. My cup of vitriol certainly does runneth over here. But I’d rather hear from you first about what you think should be done. So please fire up you emails and let me know!

Hi, Mr. Moeller. I read your article, and this is why I am bloody mad.

This same thing happened last year. Now I have to worry about this year. I am past full retirement age, but am stalling to collect my Social Security, because it is the only “savings” that is paying 8 percent a year, or so they tell me.

The longer I wait, the bigger the amount of my monthly payment. Since I am facing so many inflationary expenses (property taxes, homeowner’s dues/condo assessments, etc.), I thought I should try to hold out.

The problem is that this darn Medicare Part B is rising, and it’s NOT RIGHT — especially for only 30 percent of the beneficiaries (I’m one of them) STUCK paying for everyone else with ridiculous out-of-control increases. THIS CANNOT STAND and must be fixed, not only for 2017, BUT ENTIRELY.

Last year, I called everyone in WASHINGTON who I thought would get on this right away, and of course, there was NO RESPONSE, other than congresspeople telling me don’t worry, eventually they’ll get to it. That is outrageous. Unacceptable. Things have to change.

What is your opinion on my waiting to collect Social Security (which I was planning on doing 12 to 15 months from now? (I would get about $1,500 to $1,600 extra a year). Right now, I have NO income. I am only living off of some savings that are at almost 0 percent interest.

This whole situation is KILLING SENIORS. I can’t believe that no one in the government is doing anything to help seniors other than make their lives miserable and actually try to kill them off. It’s disgraceful.

I would love your thoughts on this situation and anything you can tell me about it. Why do they take so long to decide until the last day of the year, making it impossible for people to plan their lives, budgets and financial plans?

Please let me know how you feel about Melinda’s take on the COLA and how it is affecting Medicare premiums.

As long as we’re in the neighborhood of dubious government rules, I’ve got another one to share. This doozy is about Medicare and involves an ill-named program called “seamless conversion.” Under this program, the government has the option of empowering private Medicare Advantage insurers to automatically enroll you in one of their plans, possibly without your knowledge and certainly without your approval. Fortunately, this program does not appear to be heavily used these days. But a bad idea is still a bad idea, and I wrote words to this effect last June.

READ MORE: Beware of being automatically enrolled in a Medicare plan you don’t want

Well, Medicare rarely comes right out and says it goofed. But late last Friday — the preferred time for organizations to issue unfavorable, embarrassing news — Medicare said it would temporarily suspend allowing any new insurers to use the program. Further, in a belated transparency move, it released information identifying the 29 Medicare Advantage insurers and their 59 different insurance plans that have been approved to engage in such conversions. Please review this list if you believe you’ve been subjected to this tactic.

“CMS is reviewing its policies for the optional seamless enrollment mechanism in light of recent inquiries regarding the mechanism, its use by [Medicare Advantage] organizations, and the beneficiary protections currently in place,” the agency said in its public announcement. It also noted that it doesn’t know how many such conversations have actually occurred! Lacking this information, the decision to suspend new participants reflects at least some ugly optics surrounding the program if not outright consumer abuses.

And now, what would an Ask Phil be like without some actual Ask Phil items?

Susan: My husband (age 73) has Humana Advantage coverage in the U.S. We will be residing in Hong Kong for a number of months, and he will need to have follow-up testing to monitor for kidney function (kidney recently removed) and cancer screening. Hopefully, these are only tests (not treatment). Please advise if there is a Medicare plan that will work for him as it is now time to reevaluate his options.

Phil Moeller: Medicare generally does not cover medical care outside the U.S. There are some Medigap policies that cover foreign care outside the U.S., but they cover only emergency treatment and not the kind of medical testing you mention in your note.

READ MORE: Are you prepared for Medicare open enrollment?

I am not sure how expensive these tests will be or what other health expenses both of you might incur. If it were me, I’d explore getting in-country health coverage and just continue to pay the Humana premiums while I was away.

I realize this is hardly a low-cost solution, and I’ve railed against Medicare’s non-coverage of care outside the U.S. In many cases, people can get superior and cheaper medical care outside the U.S., and doing so would save money for the Medicare program. As you can imagine, however, U.S. health care providers and insurers are hardly big fans of this!

Julie: I just finished the Medicare book. It is an excellent resource just like “Get What’s Yours” for Social Security. Thank you! My parents are both on Medicare Advantage plans (Kaiser Senior Advantage). It is my understanding that they cannot purchase Medigap policies to help defray additional out-of-pocket costs. If that is the case, what options do they have to help defray additional costs? They won’t qualify for long-term care insurance policies due to preexisting conditions. Any advice you can provide would be greatly appreciated.

Phil Moeller: Thanks for reading our books and for your kind words.

Yes, it is against the law for someone to have both a Medicare Advantage plan and a Medigap plan. Normally, Medigap plans do a better job of protecting a person from out-of-pocket costs than does Medicare Advantage. But it depends on the specific policies involved. Generally, each of them has out-of-pocket safeguards.

READ MORE: What Clinton and Trump propose for Social Security and Medicare

However, neither policy insures against long-term care expenses. Until and unless Congress tackles this problem, the only protection is for your folks to sock away more money in savings against the day when one or both of them will need long-term care. As you may know, if they run out of money, they can go onto Medicaid, which does cover long-term care. However, this is not an outcome anyone should look forward to.

In terms of defraying additional costs, I don’t have any easy fixes. They could explore group living arrangements to lower their current housing costs and also benefit from a broader support structure. They could move in with you (or vice versa) to lower expenses and also provide on-site help. These choices boil down to some form of downsizing that reduces current living expenses and builds up savings. Best of luck.

George: I read your article in the paper on Part A. I will turn 65 in February 2017 and will continue to work for a very large employer with whom I have health coverage. I will not collect Social Security. Am I allowed to sign up for Medicare Part A? Would it be considered supplemental? My wife will turn 68 in January 2017 and is covered under my work plan and does not collect Social Security. Is she allowed to sign up for Part A? Would it be supplemental?

Phil Moeller: You can elect to receive Part A when you turn 65. Because you qualify for Social Security, you don’t need to pay a premium for Part A.

I am not sure what you mean by Part A being supplemental. It can be what’s called “secondary” coverage, helping to pay covered hospital expenses that are not fully paid by your employer insurance. In this case, you would most likely need to pay any of your private insurance deductibles before Part A coverage is available.

Getting Part A makes sense to me unless you have a high deductible health plan with a health savings account. Tax-free contributions to HSAs are not allowed if you are on Medicare, and having Part A is considered being on Medicare.

Lastly, as your spouse, your wife is also eligible for premium-free Part A even if she has not worked enough to qualify for her own retirement benefits from Social Security.

Julie – Minn.: I’m 64 with a high deductible health insurance plan ($3,500 out of pocket plus $600 premiums — plus employer contribution — annually) through my employer and will begin Social Security at age 66 (my full retirement age). Is there a Medicare plan(s) that can mirror my existing coverage for the same amount of money? I’m going to live on a fixed income in retirement and planning for medical costs is a primary concern. Thanks for your help!

Phil Moeller: Great question!

Other than paying $4,100, I don’t really know how your insurance policy pays after that for covered expenses. Does it pay all of them or have a co-pay? Do you have a hard cap on your annual out-of-pocket expenses?

Looking only at the $4,100, I’d think you can find comparable Medicare coverage (but I’d stress again that it depends on details of your current coverage).

READ MORE: Signing up for Medicare? Read this cautionary tale first

The premiums for basic Medicare are $0 for Part A and, for most people, $104.90 a month now for Part B. Your Part B will be more expensive – at least $121.80 a month and possibly as high as $149. Each also has its own annual deductibles and, for Part B, copay requirements. Average premiums for Part D drug plans will be about $42, but that may require a $400 annual deductible and several thousand in potential out-of-pocket costs depending on the drugs you take. You then could get a Medigap plan to plug holes in basic Medicare. These policies easily can cost $200 or more a month, depending on the type of plan you get.

Alternatively, you could get a Medicare Advantage plan that includes basic Medicare, Part D coverage and out-of-pocket protection that can be comparable to a Medigap plan. Again, it will depend on the specifics of the policies. You normally have to pay the Part B premium in addition to a Medicare Advantage premium. Still, these plans usually are less expensive than having basic Medicare, Part D and Medigap.

There can be downsides to Medicare Advantage. These plans usually require enrollees to use doctors and hospitals in the plan’s provider network. These limitations can make it hard to get care from preferred docs and hospitals, especially if you have a serious health condition where seeing specialists becomes a priority.

The best advice I can provide is to read past Ask Phil Medicare columns that explain these matters in more detail. You can also find these answers in my new book, “Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs.”