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 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.
Medicare and Social Security are of critical importance in enabling older Americans to age in good physical and financial health. To support these broader goals, “Ask Phil” is expanding its mission.
Where to start? I am so glad you asked! I have written what seems to be countless stories and received thousands of questions from readers about facets of what I call successful aging. I wish that success meant that we’d all live forever and avoid stormy weather during our journeys. Of course, it does not.
Successful aging means aging with as much physical well-being, financial security and dignity as possible. To this I would add the nebulous but critically important goal of living a life that is satisfying, or at least satisfying enough that the view from your death bed is not one of regret. I co-authored a book about this in 2012 called “How to Live to 100.” While I am not sure I would want to live that long, I am sure that the required elements of a long and successful life are very much worth paying attention to.
Here, then, is a laundry list of aging topics that I hope will help prime your “Ask Phil” pump and prompt questions that you would like addressed.
Purposeful time: volunteering, education, giving back and worship
Leisure time: travel, entertainment and hobbies
Family and social relationships
Estate and legacy issues
What does your finish line look like?
Budget deficits and senior safety nets
Technology, self-driving cars and senior independence
Longevity, demographics and implications for aging
Alzheimer’s and dementia
Who will take care of us?
Budgets and spending
Financial fraud and abuse
Retirement, non-retirement and pre-retirement
Workplace issues for older employees
Aging in place at home
Age-friendly homes and communities
Reverse mortgages, home equity and other housing issues
This list is not meant to be complete or exclusive. If you have questions about other things that are shaping your own experiences with aging, please send them my way.
And now, here are this week’s reader questions.
Cynthia – Texas: Where can I get some help with Medicare questions? What is SHIP? I will be 65 in July and need some help. Also, my husband is 66 years old and has been receiving Social Security since he was 62. I am still working. Can I file under his Social Security to receive a spousal benefit?
Phil Moeller: SHIP is shorthand for the State Health Insurance Assistance Program. It provides free Medicare counseling and has local experts in your home state. President Trump’s current budget proposals would eliminate all of SHIP’s annual $52 million in funding, continuing recent Republican efforts to eliminate this source of free help to consumers. While Medicare’s own information services can be very helpful, they do not do a very good job of helping consumers navigate Medicare’s seemingly countless complexities. That $52 million, by the way, supports an enormous volunteer network of thousands of consumer counselors. Medicare would need to spend many times this amount to replace what SHIP does.
As far as your Social Security question is concerned, you can file for a spousal benefit if you are at least 62. However, these benefits will increase every year until reaching their maximum amount when you reach your full retirement age of 66.
Also — and this is big deal — if you file for a spousal benefit before you turn 66, Social Security will deem you to be simultaneously filing for your own retirement benefit. You would be hit with early claiming reductions on both benefits. Worse, Social Security would not pay you each benefit, but only an amount roughly equal to the greater of the two.
Because you already had turned 62 as of the beginning of 2016, you are grandfathered in under new Social Security laws. Under this provision, if you waited to file for a spousal benefit until you were 66, you could file what’s called a restricted application for just your spousal benefit while deferring your own retirement benefit until as late as age 70, when it would reach its maximum amount.
Richard – Minnesota: I have a disability that forced me to stop working as a registered nurse. My former employer provided me a wonderful benefit to continue my health plan at the same payment rate until I turned 65. However, after I received Social Security disability benefits, I now find that I can no longer use this plan as my primary insurer if I sign up for Medicare. So I will have to go onto my wife’s employer health plan. In either case, the expense is raised by thousands of dollars each year. Why does the government find this a reasonable way to treat disabled persons?
Phil Moeller: I am sorry you are finding out in such a negative way that Medicare is not always reasonable. It is, however, usually logical. Your former employer’s plan apparently is designed so that it ceases to be the primary payer of health claims when you turn 65 or, at least in the plan’s eyes, are retired. Most retiree plans require Medicare to become the primary payer of claims, with the retiree plan becoming the secondary payer. This provision holds down employer expenses and is a major reason why they offer retiree plans at all.
If you get Medicare, even if you had not yet turned 65, this apparently triggers the provision that your former employer’s plan become a secondary payer. I can understand that you feel you have no choice but to be covered under your wife’s plan and that either Medicare or her plan will cost you a lot more money than you were paying.
In this case, I don’t think your disability is the cause of your problem. Rather, it’s that your former plan would view you as a retiree if you went onto Medicare. You would be treated this way whether or not you were disabled.
By the way, finding a health policy on Minnesota’s state Obamacare insurance exchange might be another option. While these rates have been increasing and Republicans would like to end Obamacare altogether, this could be a less expensive option for you than moving to your wife’s employer health plan.
Eugene: I am reading your Medicare book and think it should have mentioned the U.S. Family Health Plan. This plan works with Tricare and covers former military members in some parts of the country, allowing them to avoid needing to sign up for Medicare after they turn 65.
Phil Moeller: Thanks for mentioning the U.S. Family Health Plan. It’s always hard to know how much detail to go into for situations that are not widespread, and this is one of them.
According to Tricare, there are slightly more than 100,000 members in this health plan, which is the only one of its kind. This is a little more than 1 percent of about 9.4 million Tricare members.
Even though Medicare is not required for people in this plan, its limitation to only six regions of the country prompted Tricare to tell me, “We strongly encourage these beneficiaries to enroll in Part B when they first become eligible. If they disenroll from USFHP, or move to a non-USFHP area, they won’t be eligible for other TRICARE benefits if they don’t have Part B. And, if they don’t enroll in Part B when first eligible, they may be required to pay the Medicare Part B Late Enrollment Penalty.”
Dan – Texas: I have been trying to find home care (unskilled) for my 83-year-old mother. She has Medicare, but also has a Humana policy. It covers 35 hours a week, but every time I try to get assistance, I am denied. I don’t understand why we can’t get her the desperate help we need for her. My mother has Alzheimer’s and dementia and is the widow of a veteran.
Phil Moeller: Sadly, Medicare does not cover most unskilled home care. This is not Humana’s fault, but it is a Medicare rule.
If you don’t have a doctor’s recommendation, I am not surprised you are being rejected for coverage. Might your doctor prescribe such care as medically necessary? Even if he has, and she qualifies for Medicare’s home care benefit, the challenge is to find a home-health agency to provide it.
This has become an enormous problem. Even though this is a covered benefit, it seems that many home-health agencies simply do not want to provide these services. There are lots of reasons — other care is more profitable, they have staff shortages, etc. But the bottom line is that it is very, very hard to get this care.
Humana should have a list of recommended home-health agencies. Medicare also maintains an online list of registered agencies and has a rating system to grade their performance. Even so, it can be very hard to find an agency willing to take on a client such as your mother.