Did ya know: If you disenroll from Medicare, you give up your SS?

[samclem]

I'd never heard before that anyone who disenrolled from Medicare also lost their entitlement to Social Security.
I'm sure most of us plan to take whatever Medicare offers and be satisfied--that's the default position. But I never knew that if someone turned it down they'd, technically, also be turning down their SS checks. Strange but true. From the story at this link (WSJ). Emphasis added.

It remains a remarkable fact that America obliges most citizens over the age of 65 to take that rickety government health plan known as Medicare. Judging by today's growing number of health-savings options (HSAs, medical FSAs), some Americans would prefer to maintain private coverage upon retirement, rather than be compelled into second-rate Medicare. Yet the idea of patient choice offends many in government, and in 1993 the Clinton Administration promulgated so-called POMS rules that say seniors who withdraw from Medicare Part A (which covers hospital and outpatient services) must forfeit their Social Security benefits.
Several senior citizens in 2008 challenged the government, suing to be allowed to opt out of Medicare without losing Social Security. The plaintiffs paid their Medicare taxes through their working lives and are not asking for that money back. They simply want to use their private savings to contract for health services they believe to be superior to a government program that imposes price controls and rations care. They also dutifully contributed to Social Security and—fair enough—prefer to keep those benefits.

As recently as the fall of 2009, Judge Collyer provided support for the plaintiffs. She rejected the Obama Administration's argument that the plaintiffs were lucky to get Medicare and therefore had suffered no "injury" and lacked standing. . .

Yet in a stunning reversal, Judge Collyer last week revisited her decision and dismissed the case. In direct contravention to her prior ruling, the judge said the Medicare statute does—with a little creative reading—contain a requirement that Social Security recipients take government health care. The Medicare statute provides that only individuals who are "entitled" to Social Security are "entitled" to Medicare. Therefore, argues the judge, "The only way to avoid entitlement to Medicare Part A at age 65 is to forego the source of that entitlement, i.e., Social Security Retirement benefits."

. . . This is convoluted enough, but Judge Collyer's truly novel finding comes with her implicit argument that to be "entitled" to a government benefit is to be obligated to accept it.

The article goes on to note that we, as taxpayers, should be happy if anyone wants to withdraw from Medicare--it's money saved for treatment of others. But there are others who see it as very important that everyone be forced into the same leaky boat. The Executive Branch argued that individuals should lose their SS checks if they withdraw from Medicare.


This same reasoning surely applies to the current efforts to put those under 65 into (government standardized) plans. "If you're not happy with what you are offered, apply pressure for better benefits for everyone." It will be a vary painful cost spiral.

 

[Gumby]

Why can't you have both private healthcare and Medicare if you want? Or, to put it another way -- how does it harm you to have Medicare?

 

[RetiredGypsy]

? Or, to put it another way -- how does it harm you to have Medicare?

Maybe they're more concerned with who all has to pay for it for them to have it? Or that they're forced into it, with or without their consent?

 

[samclem]

Maybe they're more concerned with who all has to pay for it for them to have it? Or that they're forced into it, with or without their consent?

That could be.

I dunno. Maybe if you are a Medicare participant you can't find a private policy that isn't a secondary payer (behind Medicare), and maybe they use Medicare's rules for deciding on standards of care. I really don't know.

More importantly--why should any branch of the government be working to pressure citizens to take benefits they don't want? Especially from a program that is careening toward insolvency.

And, why should SS benefits be denied to anyone just because they want their name removed from the Medicare list?

Are those who qualify for Medicaid, Section 8 housing vouchers and free school lunches forced to take everything or nothing? Of course they aren't. This Medicare case is all about forcing everyone, including those who might use their SS payments to buy private insurance, into the same bad system.

 

[RetiredGypsy]

Looking for sense and good judgment from the government? That way lies madness!

 

[Nords]

And, why should SS benefits be denied to anyone just because they want their name removed from the Medicare list?

In 20 years, when spouse & I start drawing SS, this will all be a moot point because our Medicare premiums will be roughly equal to our SS deposits...

 

[sheehs1]

Read about this tonight in the Wall Street Journal. The judge originally sided with the plantiffs arguing several points.....but then changed her position and sided with the government who was fighting the case vehemently. She said and I quote, "Americans have a legal obligation to accept subpar government health benefits". She then argued with the implied stance that "to be "entitled" to a government benefit is to be obligated to accept it". And of course as the OP stated.....".if one withdraws from Medicare they loose their social security". The plaintiffs (made up of several senior citizens) appealed it to the D.C. Circuit Court of Appeals this week.
Hard to get but so worked up about this.....as...so many things will change..who know where the target is Still...I tore it out after I read it...thinking I might look into it further.

 

[RetiredGypsy]

Is this related to the article I'd put up on another thread?
Seniors Should Be Allowed to Opt Out of Medicare - WSJ.com

EDIT: Oh. Yes it is. Same judge and everything. Okay.

 

[chinaco]

I must be missing something... why would one opt-out? This luxury is only a consideration for the truly wealthy.

Assume for a minute the Health care reform did not happen.

Any and All retirement health care plans are built based on the assumption that people will eventually be on Medicare! If that were not the case... you would see that type of benefit vanish instantly!!! The govt is carrying the risk of old age healthcare (via Medicare and our collective pooling of money... us).... NO business! NONE will carry that excessive burden!


This sounds like a political debate being played out in the courts. The far right or certain special interests must have found some foolish shill to be the lab rat in that case! Why? Only the truly wealthy would be able to afford it... and they would probably have to foot the bill themselves (no pooling of money).

Forget about buying your own insurance... you would get canceled (especially if you got sick) and not be able to buy it at any price... even healthy.... who is going to insure an 80 year old?? It does not take an actuarial genius to know what is going to happen to them... probably sooner than later!


That would merely set all of us (middle class who eventually get sick... unless one just drops dead) on the path to medicaid. What do you think would happen to medicaid if all of the elderly sick were shifted to the state?


This is a nasty situation where special interests are jockeying for position... this is 100% about who pays!


How about coming up with a real solution instead of trying the wreck the fragile safety nets in place!

 

[RetiredGypsy]

There's no incentive to serve a large population of consumers by an insurance after a certain age? There was no insurance for anyone over 65 before Medicare in 1965?

 

[martyb]

My Social Security will only be roughly $300 per month anyway, I might be better off to just stay off SS & Medicare, & just stick with only my Fed employee health insurance. I'll have to keep it & pay for it anyway...Medicare or not, or else I'll lose it. Then, there's also Tricare which I'll be eligible for at age 60, but I think it's in the same boat as my Fed insurance with regards to Medicare.

 

[donheff]

It doesn't sound like you have to give up SS to drop Medicare, it sounds like you simply can't drop Medicare -- it is universal health insurance for oldsters. Voluntarily not taking SS doesn't erase your "eligibility" for Medicare - you are still "eligible" for Medicare. Lots of 65+ers are not yet taking social security but are automatically covered by Medicare at 65. The "problem" is more likely at the other end. IIRC doctors and hospitals are not allowed to charge more than Medicare allows for Medicare covered procedures. The bottom line is these rich folks can't jump the line on the rest of us for basic - Medicare covered - hospital services because the docs can't accept those big checks. Isn't that what universal health care is supposed to be about?

 

[samclem]

I must be missing something... why would one opt-out? This luxury is only a consideration for the truly wealthy.

I must be missing something. The wealthy should have the same rights and protections as other people. If they want to opt out of Medicare and allow more Medicare resources to be used for others, why should anyone stop them? Why should the receipt of one government benefit be contingent on acceptance of (not qualification for) another one?

I agree with you--there's no doubt that there's a political motivation for this court battle--on both sides. At least one of the plaintiffs is a well-known conservative. And the person pushing the government side is a well-known liberal. That's got nothing to do with the merits of the case, and the lunatic policy it highlights.

That would merely set all of us (middle class who eventually get sick... unless one just drops dead) on the path to medicaid. What do you think would happen to medicaid if all of the elderly sick were shifted to the state?

I wish people would stop saying scary things about the Medicaid program. Half of the people who will be gaining health care coverage under the new health care legislation will get it by being pushed into Medicaid. By 2016, it is projected that 25% of Americans will be covered by
Medicaid. So, I guess someone thinks it's a good, successful program since they are expanding it. I think people who say bad things about the awful care Medicaid provides and the long waiting lists for that awful care are just trying to undermine support for the new reforms we'll soon all enjoy.

Assume for a minute the Health care reform did not happen.

No need to assume or imagine anything: Health care change happened, health care reform didn't.
(I would have included some exclamation points above, but you used them all up ).

 

[samclem]

IIRC doctors and hospitals are not allowed to charge more than Medicare allows for Medicare covered procedures.

I'm also working from memory, but I thought the rule above applied only to medical providers who accept Medicare patients. The government has no method to stop a "free agent" doctor or hospital from charging whatever the doctor and the patient (or insurance company) agree on.

Maybe that's the import of this wrangling. These people want to officially be "non-Medicare patients" and want to engage in dreaded free-market behavior: Entering into contracts with doctors as individuals rather than wards of the state. This should be allowed, no?

The bottom line is these rich folks can't jump the line on the rest of us for basic - Medicare covered - hospital services because the docs can't accept those big checks. Isn't that what universal health care is supposed to be about?

I thought universal health care was about getting everyone access to coverage, not forcing everyone into identical coverage. The present health care law allows people under 65 to buy additional coverage to pay for things not covered by one of the government-approved plans--I wonder if that's a temporary situation.

 

[grumpy]

I'm a bit puzzled by this discussion. I'm a retired Fed (CSRS) and have BCBS health insurance. I am not eligible for SS since I never paid into it. DW collects SS from her employment. I will be turning 65 in less than a year. I have talked to several other retired FEDS who determined that joining Medicare at 65 was not the best alternative in our circumstances and it is also my intention to stay with my BCBS coverage. Will this have any effect on DW's SS? What about when she turns 65 in two years?

 

[donheff]

I'm a bit puzzled by this discussion. I'm a retired Fed (CSRS) and have BCBS health insurance. I am not eligible for SS since I never paid into it. DW collects SS from her employment. I will be turning 65 in less than a year. I have talked to several other retired FEDS who determined that joining Medicare at 65 was not the best alternative in our circumstances and it is also my intention to stay with my BCBS coverage. Will this have any effect on DW's SS? What about when she turns 65 in two years?

You can keep your BCBS but it will simply supplement Medicare. You are covered by Medicare and have been paying into for decades.

Edit: I was wrong about that Grumpy. You do have a choice. Now I have to evaluate this carefully. OPM advises you to go for Part A but the question is complicated. Here is what they say:

"The decision to enroll in Medicare is yours. OPM encourage you to apply for Medicare benefits 3 months before you turn age 65. It's easy. Just call the Social Security Administration toll-fee number 1-800-772-1213 to set up an appointment to apply. If you do not apply for one or more Parts of Medicare, you can still be covered under the FEHB Program. Visit their website for forms and additional information.
If you can get premium-free Part A coverage, OPM advises you to enroll in it. Most Federal employees and annuitants are entitled to Medicare Part A at age 65 without cost. When you don't have to pay premiums for Medicare Part A, it makes good sense to obtain coverage. It can reduce your out-of-pocket expenses as well as costs to FEHB, which can help keep FEHB premiums down."

This is from http://federalretirement.net/medicare.htm -- not vetted as too their accuracy. Let us know what you ultimately decide. A lot of us will have this choice.

 

[grumpy]

You can keep your BCBS but it will simply supplement Medicare. You are covered by Medicare and have been paying into for decades.

Don,

So do I explicitly have to enroll in Medicare before I turn 65? or does that happen automatically?

 

[donheff]

IIRC doctors and hospitals are not allowed to charge more than Medicare allows for Medicare covered procedures.

I'm also working from memory, but I thought the rule above applied only to medical providers who accept Medicare patients.

I think I was "remembering" something else. If you see my response to Grumpy above, I forgot that Federal retirees could elect not to file for Medicare. I think the law requires FEHB insures in such cases to pay no more than the Medicare rate for procedures that would otherwise be covered by Medicare. I plan to look this up (now or maybe when I am closer to 65 )

 

[donheff]

Don,

So do I explicitly have to enroll in Medicare before I turn 65? or does that happen automatically?

Sorry, see my correction above, and my follow-up to Samclem. This is more complicated than I was thinking. I plan to do some research.

 

[M Paquette]

Why? Only the truly wealthy would be able to afford it... and they would probably have to foot the bill themselves (no pooling of money).

Forget about buying your own insurance... you would get canceled (especially if you got sick) and not be able to buy it at any price... even healthy.... who is going to insure an 80 year old?? It does not take an actuarial genius to know what is going to happen to them... probably sooner than later!

I just had to look. My HMO does offer non-Medicare coverage for the 65 and older set. A 0/5000 w/HSA plan for a 65 year old goes for $1,204 a month.

Ouch?

 

[Ed_The_Gypsy]

In 20 years, when spouse & I start drawing SS, this will all be a moot point because our Medicare premiums will be roughly equal to our SS deposits...

A stroke of genius by our legislators. I am in awe. Of course, I am also dead.

 

[Ed_The_Gypsy]

I must be missing something... why would one opt-out? This luxury is only a consideration for the truly wealthy.

Dear clown

,

Some of us might opt out because we may live in (for example) Mexico and expect to pay for our health care privately.

I am back to considering my fall-back retirement option of robbing a bank in Canada. In the worst case, I will get away with it.

 

[RetiredGypsy]

I am back to considering my fall-back retirement option of robbing a bank in Canada. In the worst case, I will get away with it.

As long as you don't do it like these guys:

YouTube - Barenaked Ladies-Bank Job

 

[Ed_The_Gypsy]

By a Canadian group, by the way.

Some groovy pics in that video.

N.B., incarcerated criminals in Canada go to the head of the line for health care in a country where one can die in the waiting room.

I was wrong. The worst case is they would deport me. Very bad juju.

 

[chinaco]

I must be missing something. The wealthy should have the same rights and protections as other people. If they want to opt out of Medicare and allow more Medicare resources to be used for others, why should anyone stop them? Why should the receipt of one government benefit be contingent on acceptance of (not qualification for) another one?

You are missing something! The point... if medicare were to allow people to opt out... it would be a luxury that the wealthy could afford! Bottom line: somes group have an interest in destroying the program... why? Money! The middle class would be the group exposed to financial ruin.

It is a simple point... those of us that are not rich need that program. Our current system does not provide a viable alternative. I suppose the new health reform law offers one... we could purchase it... if the program survives.

I wish people would stop saying scary things about the Medicaid program. Half of the people who will be gaining health care coverage under the new health care legislation will get it by being pushed into Medicaid.
.

I thought the working poor would get a tax credit to enable the purchase of insurance. I thought the new program was about private insurance health exchanges.

Well, I learn something new everyday. Could you post a link?