Medicare expert, Toni King explains Medicare premiums and what to do if you think yours is wrong.
My husband, John, and I need your guidance because I believe I have made a mistake enrolling in Medicare. Last year, John was laid off and lost his employer health insurance. I have enrolled in Medicare since I am turning 65 in August. John is a Veteran and is receiving his healthcare from the VA, so he did not have to enroll in Medicare and his healthcare is not costing us anything.
Why is my Medicare costing me an extra $499 for Medicare Part A and $170.10 for Medicare Part B? I thought Medicare Part A was free. Is there a form that I did not fill out? I have not worked very much since we married over 40 years ago. I was a stay-at-home mom and now I am the caretaker for our elderly parents.
Please explain what I should do to correct my Medicare mistake.
Susan, from Pasadena, TX
Most Americans do not realize that they must work a certain amount of time and pay employment taxes to have Medicare Part A with no premium. This is what your problem is – and I can help you solve your problem.
What Are the Medicare Premium Qualifications?
To qualify for Medicare Part A at no cost, you must have worked and paid Social Security and Medicare taxes from your payroll check for at least 10 years or 40 quarters (paying taxes). When you sign up for Medicare Part A, if you are not working full-time with yours or your spouse’s employer benefits, you may want to enroll in Part B, which has a monthly premium.
The premium for Medicare Part A is $499 each month if you do not qualify for premium-free Medicare Part A. If you paid Medicare taxes for 30-39 quarters, not 40 quarters, then the standard Part A premium is $274 each month.
Those who did not work or pay into the Social Security system for at least 10 years or 40 quarters and have been married for 10 years or longer, should apply for Medicare under their working spouse’s Social Security number that qualifies with the proper amount of employment time for Medicare.
If one never married or lives with someone as a domestic partner and did not work enough quarters, they will have to pay for their Medicare Part A premium.
My advice to you, Susan, would be to call your local Social Security office, since it is the government office which oversees America in Medicare enrollment. Explain that you have always been a stay-at-home spouse, but your husband has worked enough quarters to qualify, and you need to appeal your Medicare Part A premium of $499.
Toni Says: Tell the Social Security representative that you are seeking premium-free Medicare Part A because your spouse has enough quarters.
Social Security will look over both yours and your husband’s Social Security accounts to verify that he has enough quarters to qualify. Be prepared to provide a certified marriage license showing you are married, and you will have to provide the original certified marriage license (not a copy) to that specific Social Security office.
Toni KingContributing Writer
Toni King is an author, columnist, and radio and TV personality who specializes in Medicare, Social Security, and long-term care planning. While conducting a Medicare workshop in 2009, Toni was approached by a member of the audience who had received incorrect information about his Medicare Part B enrollment from Social Security. After taking a couple of days to help the gentleman straighten out his overwhelming problem, Toni’s new mission had become clear. Following more than 27 years as a top sales leader in the Medicare insurance industry, Toni would become an advocate for Americans receiving Medicare. Since then, Toni has devoted her life and career to putting Medicare into “people terms” with the help of her books, consultations, workshops, and website, ToniSays.com. Read more from Toni King.