Confused about Working, Medicare and Spouse Benefits – Ask Rusty

Dear Rusty: I will reach my full retirement age (FRA) in September of 2020 at age 66. My wife will be 64 at that time and will start drawing her SS at 1/2 of my benefit because it will be more than hers, even if she reached her FRA. My question is, I know I will need to sign up for Medicare Part A this year at age 65 but do I need Part B at this time? Both myself and my wife work for the same company and have insurance through them. I will have insurance for one more year through the company until I retire at 66. Another question is when I retire at 66 and my wife retires at age 64 at 1/2 my benefit, will she be able to sign up for Medicare because she is drawing SS benefits? Or will she have to wait until 3 months before she turns 65? Signed: Planning Our Retirement

Dear Planning: Signing up for Medicare when you turn 65 is optional if you have creditable employer coverage. If you enroll in Part A, and you have a Health Savings Account (HSA) you and your employer must both stop contributing to it the month before you turn 65. Whether you should take Medicare Part B (coverage for doctors and other outpatient services) at age 65 depends upon whether your healthcare coverage through your employer is considered a “creditable” alternative to Medicare Part B coverage. Generally, if it’s a group plan with more than 20 participants it will be considered creditable, but you should check with your HR department to make sure. Assuming your employer coverage is “creditable”, you can defer enrolling in Part B until your employer coverage ends. At that time, you’ll enter a “special enrollment period” during which you can enroll in Medicare Part B (and Part D drug plan) without a late enrollment penalty. You can enroll in Part B (and Part D) a little before your employer coverage ends so as to avoid any lapse in health care coverage.

If your wife claims her Social Security benefit at age 64 when you claim your SS at age 66, her own benefit will be reduced, and her spousal benefit will also be reduced from 50% of yours because she is claiming the spousal benefit earlier than her full retirement age. Any time any Social Security benefit is claimed earlier than one’s full retirement age it is reduced. Taken 2 years before her FRA, your wife’s spousal benefit will be about 42% of yours, not 50%.

Your wife cannot enroll in Medicare simply because she is collecting Social Security; she’s not eligible for Medicare until she is 65 (she can enroll 3 months earlier for coverage to start the month she turns 65). If your wife retires from work before she is eligible for Medicare, she may use COBRA coverage until she reaches age 65 and her Medicare coverage begins. If your wife claims her Social Security to start when she retires at 64, she will be automatically enrolled in Medicare Parts A and B just prior to her turning 65 years of age, but if she continues to work and still has creditable employee (not COBRA) healthcare coverage from her employer at that time and wishes to delay enrolling in Part B (to avoid the premium), she can do so until her employer coverage ends. Then when her employer coverage ends, she should enroll in Medicare Part B (and Part D plan) during her special enrollment period so as to avoid any future late enrollment penalties. Finally, you should both be enrolled in Medicare Part A (hospitalization coverage) because it is required to collect Social Security benefits after age 65. Medicare Part A coverage is free for anyone who is eligible to receive Social Security benefits.

This article is intended for information purposes only and does not represent legal or financial guidance. It presents the opinions and interpretations of the AMAC Foundation’s staff, trained and accredited by the National Social Security Association (NSSA). NSSA and the AMAC Foundation and its staff are not affiliated with or endorsed by the Social Security Administration or any other governmental entity. To submit a question, visit our website (amacfoundation.org/programs/social-security-advisory) or email us at [email protected].