TONI SAYS

Toni,

My problem is different from most couples that I read about in the Toni Says Medicare column. I am finding out that my company’s group health plan is not paying for any Medicare Part B medical expense since my ‘husband’ is a domestic partner. We have been together for over 25 years but never officially married. Richard is 72, and I am a 58-year-old female who now needs to learn the maze of Medicare.

Richard has serious health issues with two stents and recent back surgery, which is now costing us thousands of dollars because my company’s group health plan is not paying for his doctor’s care. Richard has never enrolled in Medicare Part B because I have always been the “working spouse.” I am discovering that the company’s self-administered group health plan does not recognize “domestic partners” as married couples, because we do not have a marriage license.

Now, Richard needs to enroll in Medicare Part B, and with him being 72, if he does not do this properly, the penalty will go back seven years. From what I have read in your articles, this could be a 70% or 80% lifetime penalty. The bottom line is, we need help!

— Gabby, Dallas, TX

 

Hi Gabby:

Enrolling in Medicare Part B for Richard is a rush job! You are now in the maze of Medicare, and Richard needs Medicare Part B ASAP. (Additional information regarding enrolling issues can be found in Chapter 1 of Toni’s Medicare Survival Guide Advanced edition.)

America needs to know the rules of Medicare regarding delaying Medicare Part B when an unmarried domestic partner receives health coverage through their partner’s employer.

The working partner should always contact their company’s health insurance benefits administrator to find out what is in the insurance company’s handbook regarding unmarried domestic partners and Medicare rules. This should be done before your domestic partner turns 65 so you can determine whether delaying enrollment in Part B is wise.

Gabby, I have written previously about the “Special Enrollment Period.” Richard will need to take the two Social Security forms, the CMS L-564 “Request for Employment Information,” signed by your employer’s human resources department, along with the CMS 40-B “Application for Medicare Part B” to his local Social Security office. Richard could have his Medicare Part B starting the first of the next month.

It is very important that Richard writes “Special Enrollment Period” across the top of each form that he is turning into Social Security. This will keep him from receiving the dreaded Medicare Part B penalty that both you and he are extremely concerned about.

During a Toni Says Medicare Consultation, we advise clients to meet with a Social Security representative in person for the added protection of being sure that the forms are received properly. One can also fax the forms directly to the specific office, or leave the forms in the Social Security office’s mail drop box, but it doesn’t necessarily mean that it will be processed correctly. Applying in person is always the best option! And always make copies of everything filed with the Social Security office.

Remember, with Medicare … what you don’t know WILL hurt you!

Toni King is an author and columnist on Medicare and health insurance issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email info@tonisays.com or call 832-519-8664. You can now visit www.seniorresource.com/medicare-moments to listen to her Medicare Moments podcasts and get other information for boomers/seniors. The publisher of Toni’s book, “Medicare Survival Guide Advanced” edition, is now offering a $10 discount to Toni Says readers and friends at www.tonisays.com and www.seniorresource.com.