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What can you do about an unwanted Medicare enrollment?

“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.


Richard – Indiana: I’m a low-income veteran and receive free care at a VA hospital, including prescription drugs. I was put on Medicare Part B without my knowledge and they are deducting those premiums from my Social Security. I did not ask for it and do not want it. They (Social Security) told me they sent me a letter to tell me how to not be auto-enrolled. I was homeless at the time, so of course did not receive the letter! They say it was my fault for not responding to the letter, and so they enrolled me. Can they put me into Medicare part B without my permission and then take money from my Social Security just because I didn’t respond to a letter I never received?

Phil Moeller: Unwanted Medicare enrollments like yours happen all the time and, in your case, it is a really lousy way to treat a veteran. It’s also a national shame that you have been homeless after serving your country. You should be able to drop Part B and have your prior payments returned to you — whether or not they sent you a letter.

Your story is one of the reasons I tell folks to never throw anything from Social Security into the trash, although in your case there was no way you could have even received such a letter. These computer-generated letters can have a big effect on your life, as you’ve sadly learned.

I would call your congressman’s office and ask them to help you get fair treatment here. Social Security pays attention to what these offices say. Please let me know how things turn out.

Victoria – Washington: I recently called my local Social Security office to apply for spousal benefits. I was told they had no appointments available for nearly three months at the earliest! They said someone would call me within 30 days to schedule an appointment and that I should call them again if this did not happen.

Today, I called Social Security’s national 800-number. I got a recording that said that all representatives were busy and that I should call back. I did call back later and got the same message. They didn’t even give me the option to hold for the next available representative. In other words, both the local and federal office are unavailable for the near future for American citizens!

Phil Moeller: Keep trying the 800 number. If that doesn’t work, call your congressman’s office and ask for help. As I told Richard, Social Security usually listens to those folks.

Social Security’s service problems have been well documented, and require immediate attention, including more funding for increased office staffing. Demand for help with Social Security and Medicare enrollment questions has soared with the aging of the U.S. population. Congress has not kept pace with agency funding. The agency has tried to cope by expanding lower-cost online services, but people often need face-to-face interaction to successfully navigate these complicated programs.

If there is a logical reason these service problems should be allowed to continue, it escapes me.

What kind of Medicare should I get?

Patti – Illinois: I need to have hip replacement surgery but want to have it in Texas. I own a single-story ranch home there, while here in Illinois I have a two-story home where it would be harder for me to recover. I just turned 65 and have applied for Medicare. Given my circumstances, which kind of coverage do you suggest that I get?

Phil Moeller: Original Medicare will cover you anywhere in the U.S. for covered care provided by doctors and hospitals who accept Medicare. Medicare Advantage plans tend to provide coverage only in your home market from doctors and hospitals in the plan’s provider network.

Some Medicare Advantage plans do provide coverage in multiple markets, but I don’t know whether any plans sold in Illinois would also cover you in Texas. You can use Medicare’s online Plan Finder to locate plans sold in your home market in Illinois, and then contact insurers to see if any offer coverage in Texas as well. If you used Medicare Advantage, you wouldn’t need a Medigap supplement plan, because Medicare Advantage plans provide ceilings on your out-of-pocket costs.
If you decide original Medicare is the way to go, then the issue with a Medigap plan is how comprehensive you want it to be. By law, all Medigap plans must cover you anywhere in the U.S., so that’s not the issue.

Different “letter” plans do have different types of coverage. I don’t see much difference for the kind of surgical procedure you’ve discussed, but I’m hardly an expert on the full range of surgical expenses. You can see the different coverages of these plans on page 11 of Medicare’s annual guide to Medigap plans.

Sherry – Ohio: I’m blessed with good health and do not have to take any prescription drugs. What would be the best Medicare plan for me if I need dental and eye coverage?

Phil Moeller: Most Medicare Advantage plans cover dental and vision. You can use Medicare’s online Plan Finder to locate plans sold where you live. Then, I’d call individual plans to find out more about the coverage you want.

Tips on waiting to file for Social Security

Isaias – Florida: I’ll be 65 this coming September 2019. I read somewhere that for me the retirement age is 66. Is this correct? I have a 13-year-old child with Down syndrome. I make too much money to get help with his care but wondered if I might get Social Security for him? I work for a large company and would like to keep working; my wife is 52 and does not work.

Phil Moeller: As far as retiring at 66, there really is no formal retirement age, unless your employer has a mandatory retirement policy. There is, however, an important date in terms of Social Security rules that might affect you.

It’s called “full retirement age” and is 66 for someone born in 1954. Once someone has reached full retirement age, any Social Security benefits they receive would not be reduced by Social Security’s earnings test, which limits benefits for wage earners who have not yet reached full retirement age.

This is important to you because once you’ve filed for your own Social Security benefit, you are eligible to apply for a benefit for your disabled child that he will receive for the rest of his life. This benefit should equal half of your age-66 benefit, so it might provide a lot of help.

While your child can be eligible for a maximum child benefit once you turn 66 and file for your own Social Security, your benefit will not reach its maximum until you turn 70. If you wait that long, it will be 32 percent larger than your age-66 benefit.

Because your son is disabled, he is eligible for a child benefit for the rest of his life. Waiting until 70 to file would deny him a child benefit until then but getting 32 percent more in your payment could be worth a lot to you and especially to your wife. Once you die, she would get that payment as a survivor benefit. Because she does not work and is much younger than you, having that extra 32 percent every month might mean a great deal to her future financial health.

Shirley – Pennsylvania: I am 60 years and have been widowed for some time. I work full-time and make approximately $45,000 a year. Am I eligible to collect my late husband’s full Social Security or just part of it? I am curious if you can help me out.

Phil Moeller: Social Security benefits taken prior to full retirement age (FRA) will be reduced and possibly even eliminated by Social Security’s earnings test. I don’t know the size of your survivor benefit if your waited until your FRA, but you can find that out from Social Security and then calculate how much it would be reduced.

The earnings test ceases to reduce benefits when a person reaches their FRA. Coincidentally, this is also the age at which your survivor benefit would reach its maximum value.

So it’s most likely a better strategy for you to wait until your FRA to claim a survivor benefit. Then, when you turn 70, you can also claim your own retirement benefit. If it’s larger than your survivor benefit, you’d get an additional payment equal to the difference.

Chuck – Florida: You had a recent column where you talked about government subsidies for Medicare. The reason Medicare is being subsidized from the general fund is because so many people did not pay at all and receive benefits. It is a tax, not an insurance program.

Phil Moeller: I’m pretty sure you will disagree with this response, but the money that the government spends for people who don’t pay Medicare and still receive benefits is not applied to the Medicare budget. Medicaid pays for the benefits of low-income people who cannot afford Medicare. Other uncompensated care is absorbed by hospitals and other caregivers.

Much of the government’s Medicare spending on Part B from the general fund goes to reduce health care spending by affluent people. Part B premiums only cover 25 percent of the costs of Part B expenses. High-income surcharges require wealthier folks to pay a lot more than 25 percent, but no one pays 100 percent, not even Warren Buffett.

If Congress decided to end Part B subsidies, the people who would scream the loudest would be the ones with money who pay for their Medicare, not the ones who don’t.

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