Journalist Philip Moeller answers your questions about health, aging, and retirement. 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.
Tina – Wisconsin: I am 64 and receive a Social Security survivor benefit. However, it is so small that I also qualify for SSI (Supplemental Security Income) and get help from Medicaid in paying for some very expensive medications that I must take. I am considering selling my country home to move into town but am scared that the money I receive from the sale will cause me to lose my current insurance support help.
Phil Moeller: You will not lose your coverage. However, your income may increase enough to make you no longer eligible for Medicaid and SSI. Should this happen, you would have to pay for these benefits through regular Medicare and would also lose your Extra Help supports.
If your income and assets (as defined in terms of Medicaid eligibility) later declined, you could once again be eligible for your current benefits. The State Health Insurance Assistance Program (SHIP) provides free Medicare counseling and should have an office in your state staffed by someone who can help you.
Charles – Virginia: I am attempting to help a person in need who has aged parents (65+), who are moving toward dementia, and a son (30+ years of age) who had a stroke and is paralyzed. She works at a nail salon and makes a poverty-level wage. What is the best place, in your view, to get information on how I can help her (straight talk) and to learn the ins-and-outs of how all of this works? She is becoming desperate and is struggling to keep her wits about her.
Phil Moeller: As you’ve clearly ascertained, she is in a very tough spot, and you are on the side of the angels in trying to help her.
I’d start with a Virginia office of the State Health Insurance Assistance Program (SHIP). This national program provides free Medicare counseling and should be able to explain some of the options.
If her parents are of modest means, it’s possible they could qualify for Medicaid, which does pay for long-term care services in both the home and in nursing facilities. Medicare does not support such care, and it’s very expensive to afford on one’s own.
In terms of her son, if he’s considered disabled by Social Security, he would also be eligible for Medicare/Medicaid. If he became disabled prior to age 22, he also would be eligible for lifelong Social Security benefits on one of his parent’s work records (assuming he’s not already receiving them).
Let me know how things go and if she has further questions.
Ardyce – New York: My husband is 67 years old and is covered as a dependent under my active employee medical insurance plan. He has been out of work and is now considering taking his Social Security benefit. He already has Medicare A, and I know that he does not need to enroll in Medicare B since he has my active employee benefit insurance coverage. However, is he required to get Medicare D for prescription medications when he files for Social Security? I don’t have drug coverage with my employee insurance at this time but can enroll for 2020 during my next open enrollment period.
Phil Moeller: There is no connection between Social Security and Part D, only Part A.
However, because he is eligible for Medicare (by virtue of being 65) his ability to stay on your employer drug plan hinges on that plan’s coverage being credible — i.e., at least as good as a typical Medicare Part D plan. Most employer plans are meet that requirement, and your employer’s plan is required under Medicare rules to certify each year that its drug coverage is credible.
If, for some reason (related mostly to high-deductible plans), your plan’s drug coverage is not credible, then your husband would have to get a Part D plan. In this event, he would NOT need to first get Part B but is eligible for D simply on the basis of having Part A.
Yes, Medicare is way too complicated!
Deb – Florida: Five years ago, we sold our home to our son and began full-time RV-ing. We have been using our old address for mail and voting purposes and spend winters in the South Florida area. We plan to begin using a mail forwarding service in northern Florida beginning next month and will change our mailing address with Medicare. My husband is already on Medicare. I will be applying for Medicare in a few months. I plan to continue using my current doctors in South Florida. Will this be a problem or cause Medicare to void my coverage since my premium would be based on a northern Florida zip code, and I would be using my Medicare coverage predominantly in southern Florida?
Phil Moeller: Medicare is not going to void your coverage. Parts A and B of Medicare cover you anywhere in the U.S. However, private Medicare insurers — Part D drug plans, Medicare Advantage plans, and possibly even Medigap supplement plans — might have issues with you living in a different part of the state. If you plan to apply for any private Medicare insurance plans, you should contact the plan ahead of time and find out how best to proceed.
Medicare rules for ex-pats
Sue and Hank: My wife and I, 72 and 74 respectively, have had Medicare Parts A, B, and D for a number of years but have been living in a foreign country, where we have been granted dual citizenship and have joined the national health insurance program. It is less expensive than U.S. Medicare and helps manage our health and medical needs here. We have maintained our Medicare coverage for use whenever we return to U.S. We are planning to return to the U.S permanently in two years. Is it possible, as well as wise, for us to cancel our Medicare now to save some money, and then reenter the program when we return to the U.S.?
Phil Moeller: If you cancel Medicare and re-enroll in two years, you would pay lifetime late-enrollment penalties. They will equal 10 percent of your Part B premiums for each year you are late, and 1 percent of the national average Part D premium (now about $35 a month) for each month you are late.
With Part B premiums now about $135 a month for each of you, a two-year penalty would add about $54 a month to your total premiums for the rest of your life. If you dropped B, you’d save about $6,500, so it would take about 10 years for those savings to be exceeded by your cumulative penalties.
Aramais: I am 71 years old and still working while receiving my Social Security benefits. I will be retiring early next year and then moving to the Philippines. From what I have heard, Medicare is mandatory in the U.S., but I have no idea what will happen when I move.
Phil Moeller: Medicare will not provide primary health insurance outside the U.S. You will need to look into what’s available in the Philippines. If you keep your Medicare, it will only cover you for care you receive inside the U.S.