My wife turned down Medicare Part B. Now what?

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Q. My wife, who is 50, started collecting Social Security disability benefits. The amount is a joke and she turned down the Medicare Part B benefits because she is fully covered under my benefits. Now I returned at 52, and our insurance company is telling me that because I retired, it is only covering 20 percent of her claims and I’m responsible for 80 percent. We cannot get into Medicare Part B until July 2020. Is there anything we can do to get her fully covered?
— Newly retired

A. We’d need to know more about the timing of when you retired, but it’s very possible that your wife could be subject to penalties when she is able to get Medicare.

It’s also not clear if you have retiree benefits from the job or if you’re covered through COBRA.

Here’s what we can figure out based on the limited information you provided.

Twenty-four months after your wife became eligible for Social Security disability benefits, she automatically became eligible for Medicare Part A and was given the option to enroll in Part B, said Deva Panambur, a certified financial planner with Sarsi, LLC in West New York. and adjunct professor of personal finance at Montclair State University.

It seems she delayed opting into Medicare Part B because she was covered by an eligible group health plan through your employer.

Now that you are retired, your wife can sign up for Medicare Part B during a special enrollment period, which lasts for eight months after she lost coverage because you retired, he said.

“She does not have to wait until the general enrollment period,” he said. “In this case Medicare will be the primary coverage and any other insurance – such as through COBRA – will be secondary.”

Panambur said your wife can also continue to get coverage under COBRA for services not covered by Medicare but she will have to pay the full insurance premium and a 2 percent administrative fee. COBRA coverage lasts for 18 months.

“If she missed the special enrollment period, she can enroll during general enrollment period – Jan. 1 to March 31 – with Medicare taking effect in July, but you will have to pay penalties and higher premiums for not enrolling when eligible,” he said. “You can get short-term coverage offered by some providers while waiting for Medicare to take effect.”

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This story was originally published on Aug. 12, 2019.

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