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Editor’s Note: Journalist Philip Moeller, who writes widely on health and retirement, is here to provide the Medicare answers you need in “Ask Phil, the Medicare Maven.” Send your questions to Phil.
Medicare rules and private insurance plans can affect people differently depending on where they live. To make sure the answers here are as accurate as possible, Phil is working with the State Health Insurance Assistance Program (SHIP). It is funded by the government but is otherwise independent and trains volunteers to provide consumer Medicare counseling in state and local offices around the country. The non-profit Medicare Rights Center is also providing on-going help.
Moeller is a research fellow at the Center on Aging & Work at Boston College and co-author of “How to Live to 100.” Follow him on Twitter @PhilMoeller or e-mail him at email@example.com.
We interrupt today’s regularly scheduled programming to talk about the anonymous (at least publicly) hacking of the giant health insurer, Anthem, which is known under its own name but even more widely under the Blue Cross and Blue Shield brand in many states. Reportedly, records from more than 80 million current and former customers were obtained by the hackers.
“Initial investigation indicates that the member data accessed included names, dates of birth, member ID/ social security numbers, addresses, phone numbers, email addresses and employment information,” Anthem says in a special website set up to deal with the breach.
At least, Anthem says, it does not believe customer medical diagnosis or treatment information was exposed to the hackers, and that credit-card information was not accessed either.
Is there any doubt, however, that more calamitous breaches are on the way? Digital terrorists – and that’s what we should call them – will be feasting off electronic health records, which quickly are becoming our standard and eventually only medical records.
A few more hacks of this scale and it might just be more accurate to say that everyone’s personal information is out there and up for grabs. Going off the grid never looked so good, although people who need health care services covered by insurance don’t have such an option.
As bad as the hack was, it is only the tip of a very deep iceberg for Anthem’s Medicare and other customers. The episode has, for example, sparked an echoing wave of other online fraud efforts, as people send out “phishing” emails trying to convince Anthem customers to mistakenly turn over personal information.
Anthem is stressing that key customer communications about the episode will be sent in written correspondence via the U.S. Postal Service. So, as a first line of defense, you should not be replying to any emails or other electronic messages that appear to be from Anthem or one of its health-insurance operating companies. If you’re in doubt, call the company’s 800 number and confirm the authenticity of any communication that claims to be from Anthem.
Inevitably, the hacking also is creating a hoped-for field day for Anthem’s litigious “friends.” Lawsuits have been filed in several states, with more surely to follow. They allege that Anthem failed in its duty to safeguard consumers. This, too, is standard fare after someone with deep pockets either does or does not do something that someone else thinks they should not have done or should have done, as the case may be.
As the Anthem situation unfolds, we would like to hear from Anthem customers about how it’s affecting them.
And now, back to some of your Ask Phil questions.
Maryilyn – Switzerland: My husband turned 65 in October and I will turn 65 this year in April. We currently live out of the country but expect to move back to the U.S. at some point. Unfortunately, we don’t really have an idea of when that will be. We currently pay for mandatory health insurance in Switzerland and will continue to do so as long as we live here. However, we have a very high deductible on that insurance and travel back and forth to the U.S. often enough that it might make sense for us to schedule check-ups and use Medicare for preventive care. But, what should we do about Medicare Parts B and D? We do not have a U.S. residence so can we sign up without one, and if so, where should we apply?
Phil Moeller: If you expect to need substantial health care services in the U.S. at some point, you need to take a close look at paying Parts B (doctor and outpatient) and D (drug) premiums. I’m assuming here you already qualify for free Part A hospitalization coverage. The penalty for delaying Part B is 10 percent of the monthly Part B premium for every 12-month period you delay enrolling. This gets added to your monthly premium for as long as you have Part B, so it can amount to lots of money over time.
Alternatively, and I’m only kidding a bit here, you can just fly back to Switzerland should you need serious medical attention while in the U.S. That’s hardly tough duty, and you get to refill your chocolate stash at the same time! Seriously, under this arrangement, you would not get any Medicare but rely on relatively inexpensive walk-in services while visiting the U.S. Or, you could find a U.S. concierge practice that would provide all but your most serious medical needs. This assumes that you are no longer a U.S. resident and thus are not legally required to have Medicare.
If you have the extra money, however, the prudent thing is to get Medicare. You can enroll in Medicare overseas by requesting enrollment forms from the United States embassy or consulate in the country where you currently live or work. The Social Security Administration should also mail you a letter notifying you that your Initial Enrollment Period has begun, along with a form to request an enrollment packet. Be sure to keep copies of any forms that you complete and to mail them with the ability to track their delivery.
Sarah – N.C.: I have an aunt and uncle who are getting ready to turn 65. They are both going to continue to work until they are 67. They both have health insurance on their job. My aunt has been told she will not need her Part B of Medicare, so she needs to decline it and not start paying for it until she retires and loses her health insurance through her employer. My uncle, who works for a different company, has been told that he needs to be sure to sign up for Part B and pay for it even though he also has health insurance on his job. Something about Medicare being primary? How can this be? They also have been told they do not need Part D at this time because they have creditable drug coverage. We just want to make sure they are not hit with any penalty in two years.
Phil Moeller: It sounds like your uncle works for a small (fewer than 20 employees) employer. These smaller employers can require employers to get Medicare when they turn 65, where it becomes the primary payer of claims and the employer’s private health insurance moves to become the secondary, or back-up, payer of health claims. He should discuss this with his employer and make sure this is the case.
Assuming your aunt works for a larger employer, she is correct that she does not need Medicare when she turns 65, so long as she is covered by an employer plan, including drug coverage that is comparable with that offered under a Part D plan.
If you are already collecting Social Security you will be automatically enrolled in both Medicare Part A and Part B. You can turn down Part B but you will need to send back the Medicare card you received in the mail with the form you received stating that you do not want Part B. You will receive a new Medicare card in the mail that does not have Part B on it.
If you are thinking about turning down Part B, you should call the Social Security Administration at 800-772-1213 and ask if you can do that without any penalties. When you call Social Security it is important to write down whom you spoke to, when you spoke to them and what they said.
On the NewsHour, Judy Woodruff spoke to Mark Bower of Voltage Security about why hackers are targeting insurance companies.
Phil Moeller is the author of “Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs” and the co-author of the updated edition of The New York Times bestseller “How to Get What’s Yours: The Revised Secrets to Maxing Out Your Social Security,” with Making Sen$e’s Paul Solman and Larry Kotlikoff. On Twitter @PhilMoeller or via e-mail: firstname.lastname@example.org.
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