Another Medicare Question...

[Richard]

I'm soon to be 62, my wife is soon to be 64.

She's essentially retired though she's got a real estate license and wanted to dabble in that when covid first came to us so she's not done anything with her "new" (2+ years old) license.

I love what I do at work. I have some good options on my work provided insurance. I do the high deductible version which opens me up to ....a high deductible. I am on an immune suppresent that costs something like $15K/month. The drug company pays my co-pay. So my high deductible copay (something like $7,000/year if I recall) is met by them around January 15 of each year when I get that months shot..... so the rest of the year, I have literally zero out of pocket expenses. Since THEY "pay" (write it off against the $15K monthly income) my deductible, all I really have is my out of pocket expense to pay for the insurance through work. Doctors visits, procedures, prescriptions....everything is 100% covered once I hit that deductible.

Which brings me to the rest...

As far as work goes, I love what I do. Been doing it for over 30 years. Importantly, "still have gas in my tank" to continue with absolutely zero thoughts of retiring (though that day will come at some point, I know....one of my colleagues is 72.... so the job CAN continue as long as the body/mind do)

and now.....the wife.

So, if I'm possibly working until I'm age "X", my presumptions are she can stay covered by ME and then when I retire, we would both go on Medicare (presuming I retire after age 65)

This post right now, is literally the first time I've ever really delved into this as it pertains to us.... so I know little about the process, what to expect.

I again, presume that as long as I'm working, it's more prudent to simply have her covered 100% under my setup verses getting into the world of more copays and other costs. Would this be a fair presumption??

Then, as stated, keep her under my wing until "I" retire?, again, another fair presumption?


She's recently reached out to Social Security to turn that on. I let her know that if she does so AND then dabbles in real estate (we own part of several properties that she would then likely list so she's not starting with zero ammo) I warned her that she might get penalized on her SSI so might want to sell those properties first, then do it. (but I'm not sure of the rules)

I guess in the end..... we're getting to that stage in life where I need to turn my learning energy onto these topics so that we avoid obvious potholes & mistakes.

 

[Roadworthy]

The penalties on Social Security only apply if you begin drawing before your "full retirement age" which is determined by your year of birth. They also only apply to "earned income", wages paid by an employer. You are correct - it is definitely time to start retirement planning. Write your questions down and pay a visit to the local Social Security office for starters. Their answers will probably be more accurate than mine.

 

[EarPlug]

Or, Find a good CPA in your area that work in Retirement Planning. Do this now and don't guess on what the rules are.

 

[ericm979]

SS and Medicare are separate. My understanding is that you should apply for medicare as soon as you're eligible (age 65 but maybe a few months before that birthday) even if you're covered under an employer plan. There are penalties for signing up late.

This stuff should be simple and automatic, not so complex that you need to hire a consultant.

 

[ROUSTABOUT]

Dang, I been getting 20 calls a day about senior care and medi care. If I knew you had questions I could have set you up with them. You could also take my "auto warranty has expired" calls.

 

[Carl_NH]

Not knowing your specific details, yes, speak to the CPA and SS Office. With your wife @ 64 her full retirement age is probably 66.7 or so, and at that time she can collect the full amount and can make as much income as she wants and not be penalized. If she takes it early, and also makes $ in real estate she will forfeit some SS I believe.

Look at both your SS benefits, and put these numbers into a Spreadsheet, and start financial planning now, then talk to a CPA, and the SS office too.

Last on the medical, you should keep her on your work policy, but she needs to sign up for Medicare when she hits 65 and also Part A.

We are in the reverse situation I just hit full retirement age, but working and enjoy it and also carry the insurance for both of us. I will work for another 2.5 years likely, and wife is 60, so she may claim at 62. We will need to get insurance to cover the 2 or so year gap until she can get on Medicare at 65, and this is not inexpensive.

Everyone's situation is a bit different, so do your homework first and don't rush into it..

 

[Ken45101]

Your insurance will probably require your wife to enroll in Medicare (do it early, Medicare starts on the first of the month of her birthday, IOW April 1 even if her birthday is April 25.) Your insurance probably will not provide coverage if she is 65 and not on Medicare.)

She should really apply a couple of months before her birthday.

 

[npalen]

Benefits for Spouses

Be sure to brush up on "spousal benefits". My wife and I missed out on this for several years because we were unaware.

 

[oosik]

Richard - my suggestion. TBN is not the proper forum to receive accurate/qualified responses to Medicare/Medicaid questions.

Contact you local Medicare office or a qualified CPA. Everyone has differing conditions and situations that will result in differing answers.

 

[2manyrocks]

Every employer insurance plan has terms that are specific to that employer. It is literally impossible for anyone here to say whether your wife can or should stay on your plan. You need to go to your employer's HR/Insurance department and ask them specifically what their plan allows. Personally, I would want to see it confirmed in writing or see where it is documented in the plan.

Start on this process several months before she has to make a decision because you're likely going to find out (a) this is more complicated than you can imagine and (b) either people don't like to give straight up answers or they themselves don't know what the heck the plan allows but don't want others to know that they don't know. Or your HR department will refer you to the insurance company that administers your employer's plan and then they may steer you into their medicare supplement sales area. The insurance company certainly isn't going to tell you that their medicare supplement premiums are higher than those available from other companies who also have better customer service ratings. Be prepared to shop for coverage.

If your wife has or wants to go on Medicare, then she needs a medicare supplement and will need to choose among the various plans. It doesn't cost any more to go through a medicare consultant who can give you quotes on the various supplement plans and what they cover in your area. If you price shop plans and insurance company ratings, there are differences in premiums.

Another issue that comes up is that she may pick a plan that's suitable today. Next year they may jack the rates on that plan if they've had a lot of claims. So this is why people re-shop plans during the next enrollment period to see if they are still getting a competitive rate. However, if someone has a serious health issue, their options to move coverage to another carrier may be limited.

She will also have to pick a prescription drug plan and enroll in that on a timely basis or she will face a permanent lifetime penalty on her premium unless she has creditable prescription drug coverage through your work insurance which is another question to research through your HR/Ins. department at work.

If she has to or wants to go on medicare, she needs to be enrolled in new coverage on a timely basis or she may have a gap in insurance coverage if she doesn't get enrolled in new coverage before the old coverage ends.

Insurance companies push medicare advantage plans which may have a lower premium, but then she would have to stay in network for provider coverage and they can act as a gatekeeper over treatment options.

Many do not understand the complexity and the risks involved in these decisions.

You need to have a talk with your HR/Insurance department at work. I'd recommend finding a reputable medicare supplement consultant. Discuss things with your social security office because the rules seem to change all the time.

Give yourself ample time to research all your options and to understand them.