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Worried senior man with tax documents

How will my tax return affect my Medicare premium?

“Ask Phil,” aims to help older Americans and their families by answering their health care and financial questions. Phil is the author of the 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.

How do Medicare’s high-income surcharges work?

Louise – South Carolina: My Medicare premium payment went up from $134 to $189 this year, due to the fact that calculated into my 2017 taxes was a one-time lump sum retirement payment. Therefore, our adjusted gross income was above $170,000 for just one year — 2017. We just completed our 2018 taxes and our adjusted gross income is $125,000. Can I get our Medicare premiums adjusted back to $134 for the rest of the year?

Phil Moeller: Medicare’s high-income surcharges apply to an entire calendar year. Your 2018 tax returns would be the basis for reduced premiums in 2020, but the premiums would not decline before then. Social Security makes this adjustment automatically, and it should be reflected on the statement you receive later this year that includes the benefits withdrawals planned in 2020 for Medicare premiums.

Marissa: Thank you for all you do! If you sell your house but the bank gets all the money due to the mortgage, is there anything you can do to negate the IRMAA charges? I know it shows higher income, but the reality is there is no extra income. What do you suggest?

Phil Moeller: I am not a tax accountant, but my understanding is that only the net gain on the sale of your home would show up as taxable income on your tax return. So, if the proceeds on your home are going to pay off the mortgage, I don’t see how the gross sale price would flow through to you as taxable income. You should confirm this with a tax professional, but if that’s the case, your home sale wouldn’t necessarily trigger Medicare’s premium surcharges.

Help with an aging parent

Sarah: My mother is 62. She has severe rheumatoid arthritis and hasn’t worked in 25 years. My sister currently lives with my mother. Her house is a mess, dishes are piled up, trash is overflowing, her house reeks of cat urine and she spends most of her days sleeping. She doesn’t schedule or keep doctors’ appointments and my sister is afraid if she moves out, my mother will die. We’re afraid she really won’t take care of herself if no one is there. I need to know what kind of care she may qualify for. She doesn’t drive, or have a car for that matter. She has Medicaid — or maybe it’s Medicare now that she’s over 55? I’m desperate for help. Short of leaving my boyfriend, job and home in Oregon, I don’t know what to do. Please, I’ll take any advice you have.

Phil Moeller: I feel for you and all the other adult children struggling with how to help their aging parents. It’s hard enough to deal with these issues, as your sister is doing, and nearly impossible when you’re a continent away and have your own life to lead.

Your mother is too young to qualify for Medicare based on her age, but it’s always possible she has qualified because she applied for Social Security disability payments. When a person gets disability payments, they also are offered the opportunity to get Medicare.

Medicare by itself doesn’t help pay for the kind of care your mother requires. However, Medicaid would cover that kind of care, and it’s possible she may already be on Medicaid. If so, she may qualify for placement in an assisted-living facility. I won’t kid you and tell you that care in such places is always great, but from what you say, it most likely would be an improvement for your mom and would also take a lot of caregiving stress off of your sister.

The State Health Insurance Assistance Program provides free Medicare counseling and should have someone in a Florida office who can help you understand the state’s Medicaid eligibility rules.

Spousal benefits

Sharon – Virginia: I have your updated Social Security book, but I’m still confused about something. I’m 62 and my husband will turn 62 later this year. He has had cancer for two years and is doing well at the present time. Can I claim Social Security now on my record without lowering what I will get if he does not survive his cancer? Can I file for a spousal benefit without him having filed for his own benefit? We are trying to have him wait until 66 and a half since his benefits are about twice mine.

Phil Moeller: I’m sorry to hear about your husband’s cancer. Good luck to both of you.

If you file for your own benefit now, it will be locked in for the rest of your life and will not increase (except for annual cost of living adjustments). You are not eligible for a spousal benefit until he files for his own benefit.

If he passes away before filing for his own benefit, you would be entitled to a survivor benefit that would equal the benefit he would have received had he filed for Social Security on the day of his death. I know this is a bit macabre, but that’s how the agency determines survivor benefits for people who die before they have filed.

If he does file for his own benefit and you then file for a spousal benefit, you would automatically trigger the filing of your own retirement benefit. Social Security would pay you an amount equal to the larger of the two benefits.

If your husband died before you reached your own full retirement age, you could file for your own retirement benefit right away and then file for your survivor benefit, which would reach its maximum amount if you waited until your FRA to file for it. I hope this helps.

Can my employer pay my Medicare premiums?

Jacqueline – California: I will turn 65 soon. I have received news from Medicare that I will have to pay its IRMAA high-income surcharges. My company only has six employees, and I have been told that my Medicare premiums will be paid by the company. Can I make them pay for the high-income surcharges as well? Is it customary to make them pay?

Phil Moeller: I do not believe you have any legal right to force them to pay IRMAA surcharges. In fact, they have no legal requirement to help pay for any Medicare premiums. I am assuming they do so because they value you as an employee and want to keep you happy. The question with IRMAA surcharges is how far your company is willing to go to keep you happy.

Karen – New York: I am working full-time, and my husband is retired. I am 75 years old. The medical plan my company offers is pathetic and inadequate for our needs. Therefore, we are both on Medicare. Can my employer pay, in lieu of paying for the company plan, our Medicare part B charges? If I am entitled as a full-time employee to medical benefits, why can’t my company pay the cost?

Phil Moeller: If you work for a company with more than 20 employees, it is legally barred from helping to pay for Medicare. Here’s a story I wrote that explains the rules. If your employer is sympathetic, I suppose it’s possible it could give you a raise to help pay for Medicare. If not, and if the employer permits it, perhaps you’d be better off just dropping the employer plan. I’m sorry I don’t have better news for you.