Jump to content
BANGKOK 21 May 2019 21:33
Sheryl

Medicare deductions from US SS

Recommended Posts

Just started SS at full retirement age and also Part B Medicare.

 

My original notification of entitlement listed a lower payment in the first month than in subsequent months. At the time I just assumed they were prorating as I turned 66 on the 8th of the relevant month.

 

However I have since learned that they do not prorate. The difference is $134, same as Medicare Part B payment, so I assume that for some reason they deducted 2 premiums rather than one. However, my Medicare Part B start date is the same as my SS start date.

 

Is this a feature of how they bill premiums (i.e. do we always pay ahead by one month)? Anybody know?

 

 

Share this post


Link to post

When you first start Part B and the premium payment is coming from your social security pension, you pay two months premium upfront as you must pay Medicare upfront for a month of coverage....not after the month...."except when first starting Medicare."  Consider Medicare premiums as pre-pay vs post-pay.  However, when you first start Part B Medicare bends their rule a little in letting you pay the first month Part B coverage later....when you get your first SS pension payment.   

 

So, let's say you started Part B "and started drawing SS on 1 Jan....this means you get your pension payment for Jan the first few days of Feb.   On that very first pension payment in Feb SS deducts the Medicare premium for Jan and Feb....you have now paid Medicare for your Jan coverage (where they bent their upfront payment rule) and paid for your Feb coverage in advance.  

 

After than initial two months of Part B premiums it then switch to one month's Part B premium deduction from your SS pension.  Your early Mar SS pension pays for your March Medicare coverage.

 

If you were not drawing a SS pension but enrolled in Part B then the billing method starts off as a quarterly payment which include prepayment.  But you can change it to a monthly payment scheme.

 

 

  • Like 1

Share this post


Link to post

if you are living outside of the U.S. the part "B" is a waste of money, as you can only use it with in the states.

  • Like 1

Share this post


Link to post
Just now, rodknock said:

if you are living outside of the U.S. the part "B" is a waste of money, as you can only use it with in the states.

Well, if you repatriate and you haven't been paying it, your premium will be higher than if you had.

  • Like 1

Share this post


Link to post
5 hours ago, rodknock said:

if you are living outside of the U.S. the part "B" is a waste of money, as you can only use it with in the states.

Yeah, I'm with you on that, isn't Part B worthless?

 

In general Medicare is useless outside of the US, but as we all know you need to sign up for Part A at 65 just in case.

But Part B, can't you opt in at any time?

Share this post


Link to post
10 hours ago, Jingthing said:

Well, if you repatriate and you haven't been paying it, your premium will be higher than if you had.

Like 10% more per every year you delayed applying

5 hours ago, GinBoy2 said:

But Part B, can't you opt in at any time?

Yes, if your willing to pay the penalty and wait for the open enrollment period 

 

13 hours ago, Sheryl said:

Just started SS at full retirement age and also Part B Medicare.

You are lucky that it is only $134 , since the Medicare starts at the "old" full retirement age of 65, for us boomer they changed full retirement to 66 , but did not change the Medicare eligibility age, which stayed at 65.  You probably got in before a penalty due to:

 

Quote

If you’re eligible at age 65, your initial enrollment period begins three months before your 65th birthday, includes the month you turn age 65, and ends three months after that birthday. However, if you don’t enroll in Medicare Part B during your initial enrollment period, you have another chance each year to sign up during a “general enrollment period” from January 1 through March 31. Your coverage begins on July 1 of the year you enroll. source:https://www.ssa.gov/benefits/medicare/

  

That being said,  you have a full 12 months to apply and theoretically you can apply and only pay for one month of coverage but still beat the cut off.  In my case it was a real PITA since I was waiting for full retirement (66) I had to pay Part B premiums directly to Medicare before they could be deducted from my SS @ 66

 

Here is an article about it that is easier to understand than the Medicare.gov web site

 

https://www.elderlawanswers.com/turning-65-what-you-need-to-know-about-signing-up-for-medicare--8968

 

Share this post


Link to post
5 hours ago, GinBoy2 said:

Yeah, I'm with you on that, isn't Part B worthless?

 

In general Medicare is useless outside of the US, but as we all know you need to sign up for Part A at 65 just in case.

But Part B, can't you opt in at any time?

https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-late-enrollment-penalty

The 10% per year not covered increase in premiums appears to be like the individual mandate of the Affordable Care Act, so you can't wait until you get sick to sign up. US$135 a month is $1620 per year. If you pay this while living in Thailand and do not have other insurance, and get very sick but can still get on a plane, you are ready to be treated at a hospital in USA.

Share this post


Link to post
6 hours ago, GinBoy2 said:

Yeah, I'm with you on that, isn't Part B worthless?

 

In general Medicare is useless outside of the US, but as we all know you need to sign up for Part A at 65 just in case.

But Part B, can't you opt in at any time?

Not if you are a military retiree as paying the Part B premium allows you to continue your Tricare medical coverage anywhere on earth once turning 65. Tricare coverage stops once turning 65 "unless" you are enrolled in Medicare Part B.  And when you go back to the US even of a 1 day visit or permanently you are immediately covered by Medicare A/B and Tricare--dual coverage.  Climb back on the plane to go back to Thailand then you are back to just Tricare coverage.

Share this post


Link to post
Well, if you repatriate and you haven't been paying it, your premium will be higher than if you had.

Yes -- for life. 10% increase for each year you waited.

 

And while you cannot use it in Thailand you can use it back in the US. You can get all your preventive care on trips back as well as any elective procedures you might need. And have the option of returning home for other care as well, which is especially useful if your Thai/expat policy has any exclusions on it.

 

By my calculation I'll get back an average of half my part B premium cost through savings on preventive care. Another 25% I save by having been able to change to an expat health policy that is less expensive and offers better customer service but imposed one exclusionwhich I would not have been comfortable risking if I didn't have Medicare as back up.

 

 

 

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

Share this post


Link to post
  
That being said,  you have a full 12 months to apply and theoretically you can apply and only pay for one month of coverage but still beat the cut off.  In my case it was a real PITA since I was waiting for full retirement (66) I had to pay Part B premiums directly to Medicare before they could be deducted from my SS @ 66
 
Here is an article about it that is easier to understand than the Medicare.gov web site
 
https://www.elderlawanswers.com/turning-65-what-you-need-to-know-about-signing-up-for-medicare--8968
 
Actually I got in under a Special Enrollment provision (not open period) and avoided late penalty on grounds of having had insurance through employment while outside the US. People in that group are exempt from requirement to opt into Part B by age 65 provided they are insured throughout the interim.

Turned out that purchasing your own insurance if you were self employed qualified as insured through work. Luckily for me.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

  • Like 1

Share this post


Link to post
Posted (edited)
21 hours ago, Sheryl said:

Actually I got in under a Special Enrollment provision (not open period) and avoided late penalty on grounds of having had insurance through employment while outside the US. People in that group are exempt from requirement to opt into Part B by age 65 provided they are insured throughout the interim.

Turned out that purchasing your own insurance if you were self employed qualified as insured through work. Luckily for me.

 

I think I"ll be calling the Medicare folks tomorrow to explore the possibility of avoiding the 10% annual increase in Medicare Part B premiums.  I'm hoping that by being self-employed in Thailand (marriage extension) and having continuous health insurance will allow me to qualify for the Special Enrollment Period(SEP) if we return to USA.   It sounds possible but perhaps not probable.

 

Some info available on SEP available at:

http://www.medicarerights.org/fliers/Part-B-Enrollment/Medicare-Part-B-SEP.pdf?nrd=1

 

How would I get permission to be self-employed as an online consultant for foreign businesses?

Edited by gamb00ler

Share this post


Link to post

Based on my googling it doesn't sound probable either.  However, Sheryl said she did it but maybe she was covered under the group plan for the company she was working for versus a plan she bought on her own while self employed.  Or maybe she was working as an Volunteer for some International tax exempt organization that provided group health care coverage.  Below are some links/quotes from my googling....I bolded some of the text.   But yea, definitely call the Medicare folks....all they could do is say no...or maybe they say yes.


https://www.insurance.wa.gov/sites/default/files/documents/medicare-works-employee-insurance-teach-materials.pdf

Quote

 

5. How does Medicare coordinate with current employee insurance if I am self-employed? If you are self-employed and provide coverage for yourself and at least one other person, Medicare considers you to have current employee insurance. (Medicare calls this a group health plan through current employment status.) If you have coverage through an association, such as the local Bar Association, you are also considered to have current employee insurance. It is important to have current employee insurance, because this allows you to use the Part B Special Enrollment Period (SEP) if you decide to delay Medicare enrollment (see questions 9 and 11). If you are self-employed and have insurance that only covers you, you will not be able to use the Part B SEP.

 

9. What is the Part B Special Enrollment Period (SEP)? The Part B SEP spans the time that you are covered by insurance from your, your spouse’s, or in some circumstances, your family member’s current work. You have this SEP while you are covered by insurance from current work, and it extends for eight months after the coverage or work ends, whichever is sooner. This SEP only applies to insurance from current work. If you use this SEP, you will not have a late enrollment penalty for delaying Part B enrollment. There is one exception: If you are eligible for Medicare due to disability, and covered by insurance from a family member’s current work at a company with fewer than 100 employees, you will not have an SEP to sign up for Medicare if you delay enrollment when you are first eligible. You will get an SEP if you are covered by a spouse’s current employee insurance from a company with fewer than 100 employees, but you will not have an SEP if you are covered by insurance from another family member, such as a sibling. You will get an SEP if the family member’s current employee coverage is from a company with more than 100 employees. If you are eligible for Medicare due to disability and covered by insurance from a spouse or family member’s current work, make sure you understand SEP rules before making decisions about delaying Medicare enrollment. Also note that you will not get this SEP if you delay Medicare enrollment while covered by retiree insurance, or if you are self-employed and covered by an individual plan (meaning your plan only covers you). If you delayed Medicare enrollment, you would have to wait for the General Enrollment Period to enroll in Medicare, and you would likely have a late enrollment penalty (see question 10). The General Enrollment Period (GEP) lasts from January 1 through March 31 each year, and coverage becomes effective on July 1


 

 

https://www.cms.gov/Medicare/Eligibility-and-Enrollment/OrigMedicarePartABEligEnrol/

Quote

 

Special Enrollment Period (SEP) for International Volunteers

Individuals who do not enroll in Part B or premium Part A when first eligible because they were performing volunteer service outside of the United States for at least 12 months on behalf of a tax-exempt organization and had health insurance that provided coverage for the duration of the volunteer service may enroll during this SEP.

Policy for when enrollment for volunteers can occur

The SEP for volunteers is the 6-month period that begins the earlier of the first day of the month following the month for which the:

  • individual was no longer serving as a volunteer outside of the United States;
  • organization no longer has tax-exempt status; or
  • individual no longer has health insurance that provides coverage outside of the United States.

NOTE: Enrollment in Part B or premium Part A may not occur prior to the end of the IEP.

 

 

Share this post


Link to post
I think I"ll be calling the Medicare folks tomorrow to explore the possibility of avoiding the 10% annual increase in Medicare Part B premiums.  I'm hoping that by being self-employed in Thailand (marriage extension) and having continuous health insurance will allow me to qualify for the Special Enrollment Period(SEP) if we return to USA.   It sounds possible but perhaps not probable.
 
Some info available on SEP available at:
http://www.medicarerights.org/fliers/Part-B-Enrollment/Medicare-Part-B-SEP.pdf?nrd=1
 
How would I get permission to be self-employed as an online consultant for foreign businesses?
I was likewise doubtful but called and was told, several times by several different SS staff, that self purchased health insuranceby a self employed perdon qualified. I then filled out the SEP application and it was accepted.

Of course my tax returns prove the self employment and that I had insurance.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

Share this post


Link to post
6 minutes ago, Sheryl said:

I was likewise doubtful but called and was told, several times by several different SS staff, that self purchased health insuranceby a self employed perdon qualified. I then filled out the SEP application and it was accepted.

Of course my tax returns prove the self employment and that I had insurance.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

Sheryl,

  Did you have attached/include any proof.....like past/paid policy statements showing coverage?  Or you just signed a doc saying your had the coverage...they just took your word for it?

Share this post


Link to post

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Recently Browsing   0 members

    No registered users viewing this page.

×
×
  • Create New...