Unmarried Couple Facing Thousands of Dollars in Medicare Penalties

Toni,

My problem differs from most couples 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 expenses since my husband and I are not actually married. We have been together for over 25 years, but never officially tied the knot. Richard is 72 and I am 58.

Richard has serious health issues with 2 stents in his heart and a 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.” Now I am discovering that the group health plan (the company’s self-administered group health plan) does not recognize “domestic partners” as married couples, because there is no marriage license.

Richard needs to enroll in Medicare Part B. Being 72, if he does not do this properly, the penalty will go back 7 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!!

Thank You, Gail, Dallas, TX

Hi Gail,

Enrolling in Medicare Part B for Richard needs to be a rush job! You are in the middle of 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 there is an unmarried domestic partner situation, and they receive health insurance through their partner’s employer.

The working partner should always discuss delaying the domestic partner’s Medicare Part B with the company’s health insurance benefits administrator or HR department about what is in the insurance company’s handbook regarding unmarried domestic partner Medicare rules. This should be done before your domestic partner turns 65 so you can determine whether delaying enrollment in Part B is wise.

I have written about the “Special Enrollment Period.” Richard must take the 2 Social Security forms, the CMS L-564 “Request for Employment Information,” signed by Gail’s employer’s HR 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 important that Richard writes “Special Enrollment Period” across the top of each form that Richard is turning into Social Security. This will keep him from receiving the dreaded Medicare Part B penalty that both you and Richard are extremely concerned about. 

During a Toni Says® Medicare Consultation, whether in person or via a Zoom consultation, we advise clients to meet with a Social Security rep in person for protection to be 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. In-person is always the best option! Always make copies of everything filed with the Social Security office.

Remember, with Medicare… what you don’t know WILL hurt you! Need Medicare help? Call the Toni Says Medicare hotline at (832) 519-8664 or email info@tonisays.com for assistance. 

On Tuesday, July 4^th, Toni’s new book Maze of Medicare will be released on www.tonisays.com. Maze of Medicare is the first book that includes scripture and positive quotes to help relieve worry, stress, and fear about Medicare.

Medicare Survival Guide Advanced Edition

What You Don’t Know Will Hurt You!

Turning 65 in America is a milestone and one of the markers is enrolling in Medicare. But the system is so complicated, and there is a lot of false information out there.

In Toni King’s Medicare Survival Guide Advanced: Basics and Beyond, Toni gives you the critical steps you need to enroll in Medicare properly. Toni shares various situations that she has experienced with her many clients during Medicare consultations, and gives you the information and tools you need to enroll on time to avoid the “famous” Medicare Part B and D penalties.

Medicare Survival Guide Advanced helps you understand Medicare step by step…

Learn How to Enroll the Correct Way
• Still Working Past 65
• Turning 65
• VA Benefits
• Laid-off or Retiring

What Medicare Option Is Best for You
• Medicare Supplement vs. Advantage
• Losing Retirement Benefits

How to Avoid
• The Donut Hole
• Part B Penalties
• Part D IRMAA Penalties

If you are enrolling in Medicare and are confused by the commercials and telemarketers, or from the information that well-meaning friends or family members give, let Toni guide you through the maze of Medicare.

Listen to Medicare Moments

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