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 “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; and he will answer as many as he can.
Mary: I have been separated for 10 years from a very abusive man to whom I was married 23 years. I am going to finalize the divorce this year. He is 70; I am 62. I did not work for many years in the marriage as I took care of the children, household and everything else. If I file now, can I collect half of his benefit? It is still more than my benefit. I have some serious health issues, including invasive breast cancer, so I am looking at my options. I called Social Security and they were useless to the point of being rude.
Phil Moeller: It is true that the maximum amount of ex-spousal benefits is equal to half of your soon-to-be former husband’s full benefit, which is the amount he would receive assuming he filed for retirement at what’s called full retirement age (FRA). This amount is yours regardless of when he actually files for his retirement.
However, to be entitled to this large a benefit, you must wait until your own FRA to claim it. If you file for this benefit now it will be much lower than if you wait.
Having said this, you won’t be eligible to file for this benefit unless your ex- has already filed for his retirement benefit or after you have been divorced for two years. Given that he is 70, I assume he has filed for his own benefit, but your note did not make that clear.
If you are strapped for funds and simply cannot wait to file for your benefit, and he has already filed for his own benefit, you need not wait for the divorce to become final. Simply go ahead now and file for a regular spousal benefit as a married person.
Diane – Calif.: I’m 71 and have basic Medicare medical insurance along with the prescription drug plan I am required to have. I haven’t seen a doctor in more than two years because I can’t find one where I live that will accept new Medicare patients. I need to drive an hour or two to some place like Stockton or Oakland just to find medical help. Because of this, I had to go to the emergency room here in Jackson to see a doctor, and it wound up costing me several thousand dollars. Why are we required to pay for Medicare coverage that we can’t use?
Phil Moeller: I’m sorry you’ve had such problems finding a doctor who accepts Medicare and is taking on new patients. Unfortunately, there are localized shortages of physicians who accept Medicare and have openings for new patients. If you’ve not already done so, check out Medicare’s Physician Compare website and try contacting Medicare doctors near you. Also, the State Health Insurance Assistance Program (SHIP) provides free Medicare counseling and has people who know California rules. If you contact its California office, perhaps someone there can help.
Richard – Alaska: This morning we visited the local Social Security office and, after the perfunctory entrance security checks and a lengthy wait, we were informed that I could not file a restricted application for spousal benefits unless my wife was at her full retirement age (FRA). How does one counter that? Are there precedent rulings or other findings I could site that explains I could file on her record even if she took early benefits?
Phil Moeller: The person you spoke to was wrong. Once your wife has filed for her own retirement, even if she filed early at age 62, that action makes you eligible to file for a spousal benefit at any time past turning 62, assuming you have not filed for your own benefit. And if you have reached your own FRA, you can file a restricted application for just a spousal benefit while delaying your own retirement filing.
Here is Social Security’s own description for the right to file a restricted application. Look at FAQ #4. You’ll notice it says nothing about the age of your spouse.
If Social Security persists, you should ask them for the formal rule that explains this. If there is one, which I doubt, please send it to me!
Karyl: I am 66 and still working for an employer with more than 20 employees. My husband recently turned 65 and, because of health issues and less generous coverage on my insurance, enrolled in traditional Medicare A and B. He is still on my policy as well. Has his Medicare filing triggered the guaranteed coverage window for Medigap? Or, if I leave him on my ‘credible’ coverage until I retire, will he still be able to have guaranteed Medigap enrollment, even with pre-existing conditions?
Phil Moeller: Unfortunately, your husband’s window for guaranteed access rights is dated from when your husband turned 65 and enrolled in Medicare. If he had not enrolled, he would have preserved those rights for when he later lost access to your health coverage. Medigap is regulated at the state level, so it’s possible your state may have some consumer safeguards that would mitigate the impact of losing guaranteed issue rights. You could check with your state insurance department and also call the State Health Insurance Assistance Program (SHIP), which provides free Medicare counseling and has outlets in all states.
Mark – N.Y.: Before I was mandated to be on Medicare due to my disability, my health care was through my retired wife’s employment. As it turns out, since she was retired and under 65, I learned that I needed to have Part B as my coverage under her plan would become secondary. It is now three months later, and I have been unsuccessfully trying to get Medicare to provide me retroactive coverage back to my initial eligibility date. Do you have any thoughts on this?
Phil Moeller: Getting retroactive benefits is very hard, and it’s not difficult to understand why. If retroactivity was permitted, people would just avoid paying for Medicare until they had a health problem, and then seek to have the problem covered retroactively.
Having said this, there can be a basis for retroactivity when a person has expressed a desire for coverage and Medicare, for whatever reason, has failed to sign them up on a timely basis. When this happens, it’s essential for the claimant to have a “trail” of their communication with the agency. It does not sound like this is what happened to you.
I wonder if a better route for you might not be to contest whether you had to be on Medicare in the first place in order to be covered. You say that her plan required you to have Medicare because she was retired and under the age of 65. Retiree plans normally do not require people to get Medicare until they turn 65, so I’m puzzled by the pre-65 requirement. I suggest you look into this.
Because you are entitled to get Medicare, I can see why her plan might like you to get Medicare. But you should find out whether it has the power to do this. I have spoken with other disabled people who have been able to continue coverage on their spouse’s employee plan.
Linda: I was widowed at age 39, never remarried, and worked part-time while raising our daughter. Recently, I met with Social Security and concluded that I should take my own retirement and defer my survivor benefit until it reached its maximum amount at my full retirement age (FRA). I just turned 62. I am so afraid of losing my survivor’s benefits with the GOP’s desire to make changes to Social Security. What, if any, advice can you give me?
Phil Moeller: I assume that your survivor benefit at FRA is larger than your own retirement benefit would ever be. If that’s the case, you’re making the correct claiming decision.
In terms of changes to Social Security, even the harshest GOP plans do not propose changing benefits for people who are so close to retirement, such as you. So, while I share your concern about cuts to the program, I don’t think they would greatly affect your own benefits.
Annette – Fla.: I currently have my disabled husband on my work health insurance plan. I pay $650 month for the family. He recently got Medicare Parts A and B due to his disability. Should I remove him from my employer health insurance and just leave him with Medicare? He is 52 and I am 50.
Phil Moeller: You will need to do some homework to answer this question. To begin, I would compare the relative benefits of your health plan versus Medicare, as well as the costs. Medicare Part B, for example, only pays 80 percent of most claims. Unless he has secondary insurance from a Medigap plan or a limit on out-of-pocket health spending from a Medicare Advantage plan, you might be exposed to very large medical bills.
I suggest you speak with a benefits person at your health insurer and learn whether your health plan would act as a secondary insurer if your husband got Medicare, and whether this would affect how much you pay for his coverage.