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What do non-married couples need to know about getting Medicare?

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.

Christian – Va.: I will be turning 65 this year and am currently collecting Social Security benefits through early retirement. I know that I will automatically be enrolled in Medicare Part A and B but understand that I can decline Part B. The only reason I would consider declining Part B is because I am currently covered under my partner’s employer health care plan, and I therefore would be over-insured and paying more than I need to. But the question here is, will I incur a penalty in joining Medicare Part B the day my partner’s benefit ends (either through retirement or loss of her job)? The key here is that we are not married, live in a heterosexual relationship, and live in a state that does not recognize common law marriage.

Phil Moeller: You will be penalized even earlier than you think for not having Part B — from the time you turn 65, not when you lose access to employer coverage.

The right to an age-65 spousal exemption from getting Medicare does not apply to non-married couples, regardless of sexual orientation.

The Part B penalty is 10 percent a year added to your Part B premium for each full year you’re late in enrolling. That premium is now $134 a month, so perhaps you can figure out the financial consequences of not enrolling.

There also is a late enrollment penalty for Part D prescription drug plans. It equals one percent of the average national Part D premium (now roughly $35) for each month you are late in enrolling.

It’s none of my business, of course, but why not just get married? You might get tax benefits and will almost certainly benefit from qualifying for Social Security spousal and survivor benefits.

Amy: I am rather unclear on the best road to traverse. My husband died many years ago, and I believe I will be collecting Social Security under his record, as he made more money than I did. I am not making very much money at all right now as I take care of my mother and son, and I am struggling financially. Should I wait longer to file and thus get more benefits? I will turn 65 soon.

Also, while I have no health insurance, I really can’t afford Medicare right now. But I keep hearing that if I do not take it right now, I may get penalties. Is there a way to avoid them?

I really appreciate any insights you can give me. I have so little time to research this and would really like to know what the best options are and how to proceed.

Phil Moeller: Let’s tackle Medicare first. If you do not get Medicare at 65 and later decide you want it, you will face lifetime late enrollment penalties. Because your income is low, I suggest you explore whether you qualify for a Medicare subsidy program to pay some or all of your Medicare premiums. The State Health Insurance Assistance Program (SHIP) provides free Medicare counseling. If you call a SHIP office in your state, there should be someone there who can help you with eligibility rules for your state (these support programs involve state rules).

You are eligible to apply for survivor benefits right now, but they will grow in value if you can wait until age 66 to file, at which point they reach their maximum level. Here’s a link to details about how much your benefits would be reduced by filing early. If you don’t know details of your late husband’s Social Security earnings record, you should call Social Security and see if a representative is willing to help you find this information.

You also can find out your own Social Security retirement information by setting up an online My Social Security account. It will show you how much your own benefits would be at different claiming ages. While survivor benefits max out at age 66, retirement benefits grow in value until age 70. By knowing this information, you can make an informed choice.

If your monthly survivor benefit is going to be larger than your own retirement benefit (even assuming you wait until 70 to file for your retirement benefit) then you can file early for your own retirement benefit now, and then file at age 66 for the larger survivor benefit.

If, on the other hand, your retirement benefit at 70 would be larger than your survivor benefit at age 66, you can file for your survivor benefit right away and then file for your larger retirement benefit at age 70.

I realize this can be very confusing, so just break it down into step-by-step decisions and make sure all your questions are addressed before making these decisions.

Rosemary – Ore.: I have been begging Social Security to review my account for years. They insist that I have been overpaid and owe them more than $35,000. Yet my receipts and 1099 tax forms clearly show that they are in error. Now, with my ex-husband’s recent passing, I am eligible for widow’s benefits, but the payment center is withholding the additional money until they can be assured that I don’t owe them anything. But no one in that office will thoroughly review my account! I have requested that my state senator’s office get involved, and it has, but there still is no movement on the part of Social Security. What recourse do I have?

Phil Moeller: I regularly get emails from folks like you and feel bad because I don’t have any magical solutions. Social Security makes mistakes and has serious staff shortages in dealing with them. All I can suggest is to keep at it. Along the way, make sure to keep detailed records of your interactions with the agency and of the survivor benefits it should be providing.

I asked Social Security 10 weeks ago if there was a special hotline to expedite appeals such as yours. I am still waiting for a reply.

Teri – Mass.: This is a Social Security question. I’m six years older than my husband – 61 versus 55. I’d like to retire at 62 but I am not sure how to claim. My husband has a larger income than I do. Would I claim under my earnings, and would it change once my husband reaches retirement age? Am I locked in permanently under my earnings, or do I claim under his? Do I have to wait until I’m 77 to even claim? I’m so very confused.

Phil Moeller: You need to find out what your husband’s projected benefit would be at his full retirement age. He can do this if he opens a My Social Security online account. You should probably open one of these accounts as well, because it will show you the size of your projected retirement benefit at different claiming ages.

As you may know (or would if you bought my book) your retirement benefit will grow by 7-8 percent a year between the ages of 62 and 70.

The most you can ever get as a spousal benefit would be half of your husband’s FRA benefit entitlement. To get this much, you’d have to wait to file for your own retirement until your own FRA. The way the rules work, if you file for your own retirement early at age 62, this will also reduce the size of your spousal benefit later, even if you waited until FDA to claim the spousal.

By this time, your head must surely be spinning. Sorry, there’s more!

In order to even qualify to file for a spousal benefit, your husband must first have filed for his own retirement benefit. If he waits until this benefit hits its maximum level at age 70, you won’t be able to file for a spousal benefit until you are 76.

I urge people to wait as long as they can to file, unless they have health and financial issues that argue for them filing sooner. Also, if you know your spousal benefits will be larger than your own retirement benefits, it could make sense for you to file at 62 for your retirement, and then switch to a spousal when you are 76.

The right answer for you depends on the specifics of you and your husband’s benefit projections. Once you know them, you can develop some different scenarios based on different claiming ages and decide which makes the most sense.