Need help with Medicare - anyone knowledgeable please help!

[cyber888]

I'm 56 and DW is 69 yrs old.
DW has never worked, she's always been with my company healthcare insurance, and we file taxes together as a married couple.

So no free Medicare Part B (hospital insurance) for her until I turn 62 years old when I'm eligible for SS and she's eligible as my dependent, correct?

If I FIRE around 59 years old and resign from my job, she will be 72. And I may have to pay the $458/mon Medicare Part B for her. And also the $114/month Medicare Part A for her. Otherwise, Medicare will penalize her.

Now, here's my question, when I turn 59 yrs old, will Medicare still penalize my DW if we just pay $114/month for Part A (and no Part B insurance). Instead, I plan to get ACA for both of us and pay a lower insurance premium for us as a couple. I only intend to withdraw from pre-tax accounts at around $20,000 - $25,000 to take advantage of ACA subsidy. So, instead of spending $458/mo for Medicare Part B just for her. We may only be spending $300-$400/mo for ACA covering both of us and also covering hospitalization with the ACA coverage.

What do you think? Will she get penalized for only paying for Medicare Part A and not for Medicare Part B ?

Thanks in advance.

 

[ivinsfan]

You need to check this out now. Your spouse can't draw a spouse cash benefit now but not sure how the Medicare issue works.

FYI dont believe your wife can get ACA coverage past 65. It's not going to work out the way you think it is.

Call the 800 number at SS and see what they tell you.

 

[cyber888]

You need to check this out now. Your spouse can't draw a spouse cash benefit now but not sure how the Medicare issue works.

FYI dont believe your wife can get ACA coverage past 65. It's not going to work out the way you think it is.

Call the 800 number at SS and see what they tell you.

According to this article (link below), people above 65 and not qualified for medicare can get ACA coverage.

https://help.ihealthagents.com/hc/e...ill-Get-Subsidized-Insurance-on-the-Exchange-

 

[ivinsfan]

According to this article (link below), people above 65 and not qualified for medicare can get ACA coverage.

https://help.ihealthagents.com/hc/e...ill-Get-Subsidized-Insurance-on-the-Exchange-

Well the question is doesn't your spouse qualify for medicare at 65 off your record..why don't you just call and ask them?

You also said you would pay for part A and use ACA you can't do both.

 

[Sarah S]

I am virtually certain your work history will qualify your wife for free part a even though you are too young to get it for yourself. My mother was a year older than my father and I know her medicare card said her eligibility was the month she turned 65. She did not have enough work credits herself It is possible that rules have changed of course. Call and double check

 

[MBSC]

Now, here's my question, when I turn 59 yrs old, will Medicare still penalize my DW if we just pay $114/month for Part A (and no Part B insurance). Instead, I plan to get ACA for both of us...

Part A is $458 (under 30 quarters) but that is irrelevant since a person cannot have both Part A and subsidized ACA at the same time.

Can I choose Marketplace coverage instead of Medicare? If you’re paying a premium for Part A. In this case you can drop your Part A and Part B coverage and get a Marketplace plan instead.

Reference: https://www.healthcare.gov/medicare/medicare-and-the-marketplace/

But once your Medicare Part A coverage starts, you’ll no longer be eligible for any premium tax credits or other cost savings you may be getting for your Marketplace plan. So you’d have to pay full price for the Marketplace plan.

Reference: https://www.healthcare.gov/medicare/changing-from-marketplace-to-medicare/

When you retire at 59, one option is for her to only enroll in subsidized ACA. The Part B LEP calculation starts 8 months after she loses your group plan.

When you turn 62, she is required to enroll in "free" Part A under ACA rules and will no longer be eligible for ACA subsidies. However, she will not be able to enroll in Part B until the next GEP (Jan-Mar). The Part B LEP calculation stops in March regardless of when she enrolls during the GEP. Part B will have a July effective date. There may be a period of time where she has free Part A and full premium ACA while waiting on July Part B to start.

The cost of all this should be compared to enrolling in Medicare when she loses your group plan.

A.6. The Individual Marketplace Qualified Health Plans (QHPs) may be cheaper than Medicare for individuals who have to pay a premium for Part A. Can someone with Premium Part A drop Medicare and enroll in the Individual Marketplace?

Yes. Individuals who are not eligible to get Medicare Part A for free may drop both their Premium Part A and their Part B coverage (or choose not to enroll when first eligible). An individual who does not have Medicare (either Part A or Part B) can enroll in a QHP.

Before making this choice, there are 2 important points for individuals to consider:

* Individuals who do not enroll in Medicare when first eligible (during their initial enrollment period) may have to pay late enrollment penalties if they later apply for both Premium Part A and Part B.

* In addition, individuals who enroll in Medicare after their initial enrollment period ends can enroll in Medicare only during the Medicare general enrollment period (from January 1 to March 31) and coverage does not begin until July of that year.

Reference: https://www.cms.gov/Medicare/Eligib...edicare-Marketplace_Master_FAQ_8-28-14_v2.pdf

 

[ivinsfan]

Part A is $458 (under 30 quarters) but that is irrelevant since a person cannot have both Part A and subsidized ACA at the same time.

When you retire at 59, one option is for her to only enroll in subsidized ACA. The Part B LEP calculation starts 8 months after she loses your group plan.

When you turn 62, she is required to enroll in "free" Part A under ACA rules and will no longer be eligible for ACA subsidies. However, she will not be able to enroll in Part B until the next GEP (Jan-Mar). The Part B LEP calculation stops in March regardless of when she enrolls during the GEP. Part B will have a July effective date. There may be a period of time where she has free Part A and full premium ACA while waiting on July Part B to start.

The cost of all this should be compared to enrolling in Medicare when she loses your group plan.

Informative answer but did you happen to notice the wife is already 69..so what's the rational for saying she has to enroll in Part A once the husband turns 62. Where does 62 mean anything?

Once the husband loses his work insurance, won't she be denied ACA coverage, I'm wondering if full Medicare and supplement won't be cheaper then what they are paying our of pocket now.

 

[MBSC]

Informative answer but did you happen to notice the wife is already 69..so what's the rational for saying she has to enroll in Part A once the husband turns 62. Where does 62 mean anything?

Yes, I noticed she's 69. Did you happen to notice she has never worked so doesn't qualify for "free" Part A until the husband turns 62?

Once she qualifies for free Part A, she must enroll in free Part A under ACA rules. Once she enrolls in free Part A, ACA subsidies end.

 

[ivinsfan]

Yes, I noticed she's 69. Did you happen to notice she has never worked so doesn't qualify for "free" Part A until the husband turns 62?

Once she qualifies for free Part A, she must enroll in free Part A under ACA rules. Once she enrolls in free Part A, ACA subsidies end.

Don't know if this is right...can anyone actually quote a definite answer? because technically you don't qualify for Medicare until 65...so what does 62 have to do will a spousal Medicare..


I just did some reading and see conflicting statements about this Hopefully the OP will call Medicare and they can help him out...they have some twisty rules��

 

[cyber888]

Thanks. This is the answer I was looking for. Yes, she does not qualify for Medicare until I turn 62 and she will be 75, because she has never worked. I mean the only time she got a wage was jury duty .. but that's it.

Part A is $458 (under 30 quarters) but that is irrelevant since a person cannot have both Part A and subsidized ACA at the same time.

When you retire at 59, one option is for her to only enroll in subsidized ACA. The Part B LEP calculation starts 8 months after she loses your group plan.

When you turn 62, she is required to enroll in "free" Part A under ACA rules and will no longer be eligible for ACA subsidies. However, she will not be able to enroll in Part B until the next GEP (Jan-Mar). The Part B LEP calculation stops in March regardless of when she enrolls during the GEP. Part B will have a July effective date. There may be a period of time where she has free Part A and full premium ACA while waiting on July Part B to start.

The cost of all this should be compared to enrolling in Medicare when she loses your group plan.

 

[cyber888]

Don't know if this is right...can anyone actually quote a definite answer? because technically you don't qualify for Medicare until 65...so what does 62 have to do will a spousal Medicare..


I just did some reading and see conflicting statements about this Hopefully the OP will call Medicare and they can help him out...they have some twisty rules��

Yes, when I'm 62 and eligible for social security, my older DW in her 70s will actually qualify for Medicare. I won't be qualified, but she will be. In the meantime, we will most likely be on ACA until I turn 62.

 

[MBSC]

Don't know if this is right...can anyone actually quote a definite answer? because technically you don't qualify for Medicare until 65...so what does 62 have to do will a spousal Medicare..

CMS Guide to Medicare Enrollment (page 20):

My spouse has never worked and will turn 65 before I do. Can my spouse get Medicare at 65?

If you’re at least 62 and have worked at least 10 years in Medicare-covered employment, your spouse can get Part A and Part B at 65.

If you’ve worked at least 10 years in Medicare-covered employment but aren’t yet 62 when your spouse turns 65, he or she won’t be eligible for free Part A until your 62nd birthday. In this case, your spouse should still apply for Part B at 65 to avoid paying a higher Part B premium. However, if you’re still working and your spouse is covered under your group health plan, he or she could delay Part B enrollment without paying higher premiums.

Source: https://www.medicare.gov/sites/default/files/2018-07/11036-enrolling-part-a-part-b.pdf

Medicare has an eligibility tool here. Enter a 70+ y/o with no work history and no longer under a group plan married to a 62 y/o with 10 years work history. The results:

"Next General Enrollment Period begins January 1, 2021.

Am I eligible to enroll? You’re eligible to enroll in Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).

You get "premium-free" Medicare Part A (Hospital Insurance) because your spouse (living, deceased or divorced) paid Medicare taxes during at least 10 years of work.

When can I sign up? You can sign up for "premium-free" Part A (Hospital Insurance) any time because your spouse (living, deceased or divorced) paid Medicare taxes during at least 10 years of work. However, you can only sign up for Part B (Medical Insurance) during the General Enrollment Period between January 1 - March 31 each year. Your Part B coverage will start July 1.

You may have to pay a late enrollment penalty for not enrolling in Part B when you were first eligible."

 

[cyber888]

This is very helpful .. thanks MBSC