Need help with understanding Medicare

[ettedo2000]

Hello,

My husband is turning 65 in September. Normally this is a simple situation to apply for Medicare for most people, for us it is tricky.

My husband never acquired his 40 hour SS working points due to any reason, one of them is a bad car accident 20 years ago that left him pretty hurt and therefore does not qualify for SSA and I assume Medicare. I have a hard time making sense of it between reading all the info online and seeing the Plans A, B, C, and D with all the different fees and also getting all the phone calls from insurance people all day long with conflicting information I am very confused and need some help.

I am his wife an I am working and have my working points. I am also 16 years younger than him. I was told that because I am that much younger than him he be disqualified from using my working points towards his Medicare application? dWhy, I don't see that that should be so. I have been married to him for 20 years.

From what I read so far, I understand that he will get Plan B and will have to pay $ 163.00 a month for that but that is only for doctors. Now as I said, he had an accident and has been hospitalized a few times. He is currently under my health insurance plan from work. We need to have hospital coverage. Which I think is Plan A. This, however, is where I get confused since he has no working points he is not covered and will have to pay over $ 400.00 a month? What about medication. So by the time we add all this up we are gone look at $ 800 - 100 a month plan? Not really affordable to any person working or not.

Can he qualify under my working points and would that lower his monthly coast? Also what about the insurance Medicare stuff. What do I need to know, watch out for? Are they recommended, I see they have plans for 0.00 but without of pocket of 4000.00? Will that included the Plan A and B or is that a separate added plan to the Federal part they push on to you?

I really need some help. Thank you

 

[MBSC]

I assume he did not qualify for Social Security Disability Income (SSDI) after the car accident which would have entitled him to Medicare at that time.

You mentioned he is currently on your employer's insurance. Does your employer have more than 20 employees? If so, ask your employer's HR department if he can stay on the plan after age 65. If he can, the employer plan should be "primary" to Medicare but have the employer confirm their plan is "primary" (pays first). If the employer plan is primary, then he can delay Medicare Parts A/B enrollment without penalty until you retire or otherwise lose the plan. He most likely can also delay Part D (drug) enrollment without penalty if the employer confirms their plan provides "creditable" drug coverage.

Otherwise, he will need to pay for Part A until you turn 62 yrs old. When you turn 62, he can then start receiving Part A at no additional cost under your work history. He will also need to pay for Part B if he can't stay on your employer's plan. Parts A and B do not pay for everything. A local SHIP counselor can help him decide on a Medicare Advantage plan (Part C) or Medicare supplement (Medigap) for additional coverage.

CMS document on when to enroll in Medicare: https://www.cms.gov/Outreach-and-Ed...ers-and-Unions/FS3-Enroll-in-Part-A-and-B.pdf

Find a local SHIP counselor: https://www.shiptacenter.org/

 

[ettedo2000]

Thank you so much for all the information. I will talk to my employee as soon as possible since we are a big company and have a group Insurance. Hopefully, it will be primary insurance as it is cheaper for now. I also will contact SHIP as you recommended and get more information to get as educated on this as possible. The more I know the better I feel. Thank you again.