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.
Michael – Pa.: I just reached my full retirement age of 66; my wife is 62. We need to apply for Social Security benefits right now because I’ve just lost my job. My wife’s current benefits would be about $500 and mine about $2,400. If she applied for spousal benefits instead of her benefits, would we see higher monthly benefits?
Phil Moeller: I’m sorry about your job loss, and I understand that you really need the money now. Because your wife’s benefit is so small, I’d suggest that you file for your own benefit first. This will enable her to file for a spousal benefit right away. It will be reduced from what she’d get if she waited to file until her full retirement age, but it will still be larger than her own retirement benefit. Unfortunately, 2015 changes to Social Security laws make it impossible for her to file for a spousal benefit without also filing at the same time for her own retirement benefit. She will get nothing from that benefit, because it’s smaller than her spousal benefit.
By the way, if you decide to look for a new job and are successful, you may have some options about Social Security. The cleanest choice would be to withdraw from the program and pay back the benefits you’ve already received. This option is good for up to a year after you began receiving benefits. I know it might be hard to come up with those funds, but doing do would permit you to “reset” your benefit entitlements and thus increase your benefits by deferring them to a later filing date.
You also could suspend your benefits. This would avoid the need to repay any past benefits to Social Security, and it would allow you to earn delayed retirement credits until the time you unsuspended. However, under those 2015 law changes. your wife would no longer be able to receive her spousal benefit if you suspended your own benefit. In that event, suspending your benefit might no longer be attractive. You can run the numbers to decide.
Neil: My wife is 67 and became Medicare-eligible two years ago. She has no recent work record, no quarters of credit (in the last 30 years) and no retirement benefits. And she has been paying more than $400 a month for Part A. I turned 62 a few months ago, have sufficient quarters for benefits, still work, and have not yet filed for Social Security benefits.
I believe that since I’m now 62 and eligible for retirement benefits, although not claiming them, my wife should now be able to get Medicare Part A at no cost by claiming on my record. Yes? (I know she had to pay Part A premiums after her 65th birthday and before I turned 62). I’ve been told this is the case, but the Medicare representatives my wife has spoken with don’t seem to know this and we can’t (yet) seem to get her Part A premiums eliminated.
Phil Moeller: Your understanding is correct. Here is a formal explanation of this rule. Social Security handles Medicare enrollments and premiums. I suggest you call Social Security, and not Medicare, and try to get this worked out. Hopefully, citing this rule will help, should the representative not be familiar with it.
Linda – Fla.: I have always been told that I didn’t qualify for Social Security since I worked for the state college system in Massachusetts and paid into the state retirement system instead of Social Security. I retired at age 55 and began collecting my pension along with health insurance through the state system. Annually, I received a notice from Social Security that I didn’t qualify for Social Security or Medicare. I was never told that I would be covered by Medicare as my husband’s spouse once he turned 65, so I didn’t apply, and continued to participate in the state program. Years later, the discrepancy was caught by Social Security, and I signed up. But I am being charged an extra $40 a month because I failed to sign up earlier! However, for some reason, I am now receiving a small Social Security payment of $40 each month! I am confused.
Phil Moeller: Wow. What a mess!
In the real world in which we all live, you might be better off letting sleeping dogs lie, as the old saying goes. After all, your mystery payment of $40 a month cancels out the $40 late-enrollment penalty that you think you’re being unfairly charged. Once you formally engage Social Security in evaluating your situation, who knows how badly things could fall off the rails! This is an overworked agency that makes mistakes even on good days.
If it matters, your spousal eligibility for Medicare, and thus for premium-free Part A of Medicare, began when your husband turned 62, not 65. If you were out any money because you did not sign up for Medicare when he turned 62, you might be able to appeal this to Social Security. It would help if you had some of those old notices where the agency said you were not eligible for premium-free Part A. This was true as far as your own earnings record was concerned, but not true when your spousal eligibility was taken into account.
Lastly, for what it’s worth, there is no test for Part B eligibility other than being a legal resident of the U.S. for five years. However, because people need Part A to qualify for most private Medicare policies, they think of that requirement as affecting their overall eligibility for Medicare.
Lisa – Okla.: I will turn 60 in October and am planning my retirement details. My husband of 32 years received full disability at 58 and died at age 63 (five years ago). I visited a Social Security office last summer. I was told the most I could receive would be my own retirement benefit, because my benefit would be more than half of what his benefit had been. After reading your Social Security book, this seems like a spousal benefit and not a widow’s benefit. I had thought I could take my own benefit early at a reduced rate, then transfer to his when I reached full retirement age. It’s all very confusing!
Phil Moeller: You are right on both counts – your understanding is correct and it is all very confusing! Your survivor benefit is not half of his but all of his. I’m gathering from your note that this will be greater than yours, so I’d advise you to take your own benefit as soon as you can, which is age 62. Then, when you reach your full retirement age, you would apply for your survivor benefit, which will have reached its maximum amount at that time.
If you will be 60 this fall, it means you were born in 1957, and that your full retirement age is 66 years and six months. When you file for your survivor benefit, you should receive an additional payment each month equal to the amount by which that benefit exceeds your own retirement benefit.
Make it clear when you file for your own retirement benefit that you are filing only for that benefit, and that you will file for your survivor benefit when you have reached your full retirement age.
Anonymous – Mich.: I’m 63 and retired, but still have health insurance through my employer. At what point do I file for the Medicare coverage? I’ve heard six months prior to reaching 65 but I want to be sure.
Phil Moeller: You need to find out from your former employer what happens to your health coverage when you turn 65. Most employer retiree health plans require people to get Medicare when they turn 65. At that time, Medicare becomes the primary insurer and the employer plan becomes secondary, and can help pay claims that Medicare does not fully cover. If this is the case, you will have a seven-month initial enrollment period that begins three months before your birthday, and includes your birthday month and the following three months.
I urge people to sign up early during this period, and thus make sure they have no break in their primary health insurance coverage. These are things you can confirm with the employer plan.
Brandi – Fla.: Twice in the last two years my 80-year-old father (with Alzheimer’s) has mysteriously had his Medicare switched from an all-expenses-paid plan (including prescriptions) to the PPO Florida Blue plan. Florida Blue says Medicare made the switch, and Medicare says that Florida Blue made the switch!
Who in their right mind would switch a man with a monthly income of less than $1,200 from a free plan to one with a $53 monthly premium and co-pays? And this has happened TWICE! He didn’t sign up for it, and as his legal power of attorney, I didn’t sign up for it either.
Meanwhile the medical bills are in the thousands, and he has been denied some medical care that Medicare would have covered. I haven’t paid these premiums, and he doesn’t even know what premiums are at this point. I don’t feel we should have to pay a dime (although he paid some medical bills and prescriptions before I caught on). Does this happen to anyone else? Don’t they need a signature? If they can’t prove we signed up then how can we be held accountable?
Phil Moeller: Fair or not, in some circumstances, Medicare health plans do have the authority to assign people to a plan without their permission, although it’s my understanding that they have a legal responsibility to tell them this is happening.
Having said this, I do not know if this is what has happened. It sounds like your father is on Medicaid as well as Medicare. Because Medicaid eligibility and related rules are affected by state rules, I would not hazard a guess as to what has been going on with your father’s coverage.
There are a couple of Medicare nonprofits that sometimes help people with these kinds of problems. It’s their call whether to try and help or not. The two I have in mind are the Medicare Rights Center and the Center for Medicare Advocacy. I hope one of them can help you. And please let me know how things turn out for your father. Perhaps you can learn things that will help others as well as him.