MEDICARE Question

EVENKEEL · November 20, 2022

So when I retired at age 62 I was able to keep my International Blue Cross/BS insurance. Now at age 65 they are auto withdraw for Medicare and part B which Jan 2023 will cost me $250/mo.

Question is can I decline medicare or is it mandatory? At some point in my life I may live in the US again, possibly.

Etaoin Shrdlu · November 20, 2022

Medicare Part A does not require payment of a premium and you should enroll at 65 during your enrollment period. I am not aware of any reason not to do so during your enrollment period at age 65.

If you don't sign up for Part B when you enroll in Part A when you turn 65, you will be assessed a penalty of 10% of the premium amount for each 12 month period that you did not take Part B and pay the premium if/when you subsequently sign up for Part B. There are also restrictions on when you can enroll in Part B, so a return to the US will take planning if you want to be covered for Part B from the moment of your return.

ubonjoe · November 20, 2022

You can choose not be enrolled in part B and then get it later if you move to the US.

I didn't sign up for it when I was close to my 65th birthday.

EVENKEEL · November 21, 2022

21 hours ago, ubonjoe said:

You can choose not be enrolled in part B and then get it later if you move to the US.

I didn't sign up for it when I was close to my 65th birthday.

I didn't do anything prior to age 65. SS started deducting monthly premiums. I turned 65 Oct 2022 and this Nov started deducting $170./mo They state starting Jan 2023 I will be charged $165.90/mo for Standard Medicare Premium and $65.90/mo for part B. Because I made a real estate sale my income for 2022 was in the 100K Range which is why my part B is what it is.

Is this normal?

EVENKEEL · November 21, 2022

21 hours ago, Etaoin Shrdlu said:

Medicare Part A does not require payment of a premium and you should enroll at 65 during your enrollment period. I am not aware of any reason not to do so during your enrollment period at age 65.

If you don't sign up for Part B when you enroll in Part A when you turn 65, you will be assessed a penalty of 10% of the premium amount for each 12 month period that you did not take Part B and pay the premium if/when you subsequently sign up for Part B. There are also restrictions on when you can enroll in Part B, so a return to the US will take planning if you want to be covered for Part B from the moment of your return.

So how much are you paying for Part A & B? I'm paying $164.90/mo just for Part A

Etaoin Shrdlu · November 21, 2022

8 minutes ago, EVENKEEL said:

So how much are you paying for Part A & B? I'm paying $164.90/mo just for Part A

I pay nothing for Part A. I did not sign up for Part B as I do not expect to repatriate to the US.

ubonjoe · November 21, 2022

18 minutes ago, EVENKEEL said:

I didn't do anything prior to age 65. SS started deducting monthly premiums. I turned 65 Oct 2022 and this Nov started deducting $170./mo They state starting Jan 2023 I will be charged $165.90/mo for Standard Medicare Premium and $65.90/mo for part B. Because I made a real estate sale my income for 2022 was in the 100K Range which is why my part B is what it is.

I got a letter in the mail from the SSA offering part B. If I wanted it I would of needed to mail it back to them to get it started. Didn't want it so no need to mail it back to them.

EVENKEEL · November 21, 2022

6 minutes ago, ubonjoe said:

I got a letter in the mail from the SSA offering part B. If I wanted it I would of needed to mail it back to them to get it started. Didn't want it so no need to mail it back to them.

10 minutes ago, Etaoin Shrdlu said:

I pay nothing for Part A. I did not sign up for Part B as I do not expect to repatriate to the US.

I didn't do anything. I didn't even sign up for medicare. I turned 65 last Oct and Nov they started deducting $170. and sent a message online what I'll be paying for A & B come JAN 2023.

Guess I have to start making calls.

Etaoin Shrdlu · November 21, 2022

2 hours ago, EVENKEEL said:

I didn't do anything. I didn't even sign up for medicare. I turned 65 last Oct and Nov they started deducting $170. and sent a message online what I'll be paying for A & B come JAN 2023.

Guess I have to start making calls.

$170.10 is the Part B premium for 2022. It will actually go down by $5.20 for next year to $164.90.

Looks like you were enrolled for both Part A and Part B when you turned 65. Perhaps you were signed up automatically for both Part A and Part B when you did nothing.

When I requested that my Social Security benefits started at age 65, I was asked if I wanted to sign up for Medicare at the same time. I stated that I only wanted Part A and that's what I was enrolled in. I went through this with the Manila FBU.

I don't know if one can un-enroll from Part B. Let us know how you get on with the SSA.

Pib · November 21, 2022

11 hours ago, EVENKEEL said:

So how much are you paying for Part A & B? I'm paying $164.90/mo just for Part A

Most people do "not" pay anything for Part A...it's free as long as you had 40 quarters/10 years of work of social security credits which I assume you did. It's Part B, repeat B, that cost $164.90 for 2023 (the basic premium)....it went down approx $5 from the 2022 premium.

The wife and I have Part A and B coverage.....we each pay zero for Part A and will pay $164.90/month for Part B in 2023.

https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/what-does-medicare-cost

Edited November 21, 2022 by Pib

EVENKEEL · November 21, 2022

51 minutes ago, Pib said:

Most people do "not" pay anything for Part A...it's free as long as you had 40 quarters/10 years of work of social security credits which I assume you did. It's Part B, repeat B, that cost $164.90 for 2023 (the basic premium)....it went down approx $5 from the 2022 premium.

The wife and I have Part A and B coverage.....we each pay zero for Part A and will pay $164.90/month for Part B in 2023.

https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/what-does-medicare-cost

I'll get this straightened out. I did an online complaint through the website for SSA. Just want the Part A which I never applied for and I'm being charged.

I'll reply back with results.

taxout · November 21, 2022

There's a kicker in the Part B premium calculation. Not to get into the details, but if you're in a higher income bracket your Part B premium will go up (and up). That's why the OP will be paying more.

Onerak · November 21, 2022

I am nearing 65 and will enroll in Medicare in 2026. So, I am gathering as much information as I could for Medicare and watch all the YouTube videos about Medicare. In 2023, the basic premium for Part B is 164.90 as others pointed out provided your income in 2021 is less than 97K. To keep my Medicare part B premium to the basic, I have to keep the income in 2024 less than 97K.

1. Does the income limit increase every year or is it fixed?

2. Does the income include any withdrawal from 401K, IRA and Roth IRA?

Write now I stay 6-month in Thailand and have a high deductible health insurance with a HSA debit card. I had been stuffing my HSA debit card to its legal limit for almost a decade when I was working. It has around 20K USD. The card is acceptable in any private hospital in Thailand. I Have tested them in BPH and Saint Louis hospital in Bangkok. My current high deductible health insurance reimburses 50% outside the USA.

I will start my SS when I am 67 (in 2028) at my full FRA and the SS website shows it is $3000/month.

3. Should I start early at reduced benefits?

After a few years I may move to Thailand full time and return to USA for a month once a year.
However, I will still keep paying for my part B in case I need it in the future.

4. Need planning to keep the income less than 97K per year. Does it the income include Social security income?

I have a daughter in the USA and she has a decent job and would inherit my house in the USA and my ex-wife's house (which is my house in fact she got when got divorced).

I also have a daughter in Thailand (late age mistake or whatever you call it) and she is 15 years old. I have a house and a condo in her mother's name that she would inherit.

Do people think I need to go to a Social Security/Medicare planner (or a retirement planner) right now to get better advise for future retirement planning about approximate 500K USD that I have stashed up in 401K, IRAs and Roth IRAs? I am now drawing from my savings for expenses as I stopped working during Covid-19 and resigned from my Job in the Great Resignation

Edited November 21, 2022 by Onerak

EVENKEEL · November 22, 2022

9 hours ago, taxout said:

There's a kicker in the Part B premium calculation. Not to get into the details, but if you're in a higher income bracket your Part B premium will go up (and up). That's why the OP will be paying more.

Just spoke with the Medicare people and I'm not being charged for Part A as I thought. Because my income was 100K for 2021 my Part B was increased to $230/mo for the year 2023. Now I just have to cancel Part B. As I have BC/BS from my job when I retired.

Pib · November 22, 2022

23 hours ago, EVENKEEL said:

I didn't do anything prior to age 65. SS started deducting monthly premiums. I turned 65 Oct 2022 and this Nov started deducting $170./mo They state starting Jan 2023 I will be charged $165.90/mo for Standard Medicare Premium and $65.90/mo for part B. Because I made a real estate sale my income for 2022 was in the 100K Range which is why my part B is what it is.

Is this normal?

This all look normal to me based on what I think you are saying.

The Standard Medicare Part B premium for 2022 is approx $170/month and for 2023 it goes down a little of $165.90. AND since you mentioned your taxable income in 2022 was in the 100K range due to a real estate sale if you also had around a $100K income on your 2021 tax return (repeat 2021 tax return which you filed in 2022) and you filed as a single then you are incurring the Medicare Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium which for 2023 will be 65.90 for Part B. An important note that any IRMAA for the upcoming 2023 year will be based on your 2021 tax return....when SSA determines if any IRMAA is required they look a person's tax return from 2 year back. When 2024 Medicare premiums come out any IRMAA will be based on your 2022 tax return. Also, double check if that real estate sale or another sale was really reported on your 2021 tax return that you filed in 2022.

And regarding where you said you didn't signup for Part A or Part B, well, generally signup for Part A is automatic regardless of whether your address onfile with the SSA is in or outside of the U.S. And generally signup for Part B is "automatic" if have a U.S. address on-file with the SSA, but not automatic if having a foreign address.

https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly

https://hr.harvard.edu/files/humanresources/files/medicare_irmaa.pdf

EVENKEEL · November 22, 2022

5 hours ago, Onerak said:

I am nearing 65 and will enroll in Medicare in 2026. So, I am gathering as much information as I could for Medicare and watch all the YouTube videos about Medicare. In 2023, the basic premium for Part B is 164.90 as others pointed out provided your income in 2021 is less than 97K. To keep my Medicare part B premium to the basic, I have to keep the income in 2024 less than 97K.

1. Does the income limit increase every year or is it fixed?

2. Does the income include any withdrawal from 401K, IRA and Roth IRA?

Write now I stay 6-month in Thailand and have a high deductible health insurance with a HSA debit card. I had been stuffing my HSA debit card to its legal limit for almost a decade when I was working. It has around 20K USD. The card is acceptable in any private hospital in Thailand. I Have tested them in BPH and Saint Louis hospital in Bangkok. My current high deductible health insurance reimburses 50% outside the USA.

I will start my SS when I am 67 (in 2028) at my full FRA and the SS website shows it is $3000/month.

3. Should I start early at reduced benefits?

After a few years I may move to Thailand full time and return to USA for a month once a year.
However, I will still keep paying for my part B in case I need it in the future.

4. Need planning to keep the income less than 97K per year. Does it the income include Social security income?

I have a daughter in the USA and she has a decent job and would inherit my house in the USA and my ex-wife's house (which is my house in fact she got when got divorced).

I also have a daughter in Thailand (late age mistake or whatever you call it) and she is 15 years old. I have a house and a condo in her mother's name that she would inherit.

Do people think I need to go to a Social Security/Medicare planner (or a retirement planner) right now to get better advise for future retirement planning about approximate 500K USD that I have stashed up in 401K, IRAs and Roth IRAs? I am now drawing from my savings for expenses as I stopped working during Covid-19 and resigned from my Job in the Great Resignation

We're pretty much in the same boat regarding homes and finances. Difference is I started collecting SS at age 62. Getting $2000/mo plus a small pension. Plus at age 62 my daughter was 8 yrs old so I was able to collect $$ for her $1300/mo till she's 18 or older if she goes to college.

I don't regret taking $$ at 62.

Pib · November 22, 2022

5 hours ago, Onerak said:

1. Does the income limit increase every year or is it fixed?

2. Does the income include any withdrawal from 401K, IRA and Roth IRA?

1. Yes

2. On "taxable" 401K/IRA. A Roth IRA is not taxable/reported on your tax return.

5 hours ago, Onerak said:

I will start my SS when I am 67 (in 2028) at my full FRA and the SS website shows it is $3000/month.

3. Should I start early at reduced benefits?

Totally up to you as each person financial needs/desire and view of life expectancy is different. You'll get more per month if you wait beyond your FRA up to the age of 70. But if you start withdrawing early then of course you get a bunch of money before your FRA. A ballpark estimate is for every 1 year you started withdrawing before your FRA it will take approx 4 years of payments if you had waited till FRA to match the money you gained by stating SSA pension before FRA. Example: if your FRA was say 66 but you started drawing at 62, well, it would take approx 16 years of the higher FRA payment to match those extra funds you drew from 62 to 66.

5 hours ago, Onerak said:

After a few years I may move to Thailand full time and return to USA for a month once a year.
However, I will still keep paying for my part B in case I need it in the future.

4. Need planning to keep the income less than 97K per year. Does it the income include Social security income?

SSA/Medicare use Modified AGI to determine if you pay extra for your Part B. For the purposes of determining MAGI for Medicare premium purposes it's your tax return 1040 Line 11 AGI "plus" 1040 Line 2a Tax exempt income. Most people don't have any tax exempt income which is shown in Block 8 of a 1099INT which ends up on a Sch B worksheet which might end up going onto 1040 Line 2a.

For most folks, 50 to 85% of a person's Social Security benefits aretaxable on their tax return and ends up totaled into the AGI.

5 hours ago, Onerak said:

Do people think I need to go to a Social Security/Medicare planner (or a retirement planner) right now to get better advise for future retirement planning about approximate 500K USD that I have stashed up in 401K, IRAs and Roth IRAs? I am now drawing from my savings for expenses as I stopped working during Covid-19 and resigned from my Job in the Great Resignation

Up to you....if you don't feel comfortable go with a planner. But IMO there is so much good financial planning info on the internet now days unless a person has a lot of various investments and don't want to educate themselves with all the good, free info then go with a financial planner. And watchout for those planners with high fees and primarily recommend sponsored investments.

EVENKEEL · November 22, 2022

1 minute ago, Pib said:

This all look normal to me based on what I think you are saying.

The Standard Medicare Part B premium for 2022 is approx $170/month and for 2023 it goes down a little of $165.90. AND since you mentioned your taxable income in 2022 was in the 100K range due to a real estate sale if you also had around a $100K income on your 2021 tax return (repeat 2021 tax return which you filed in 2022) and you filed as a single then you are incurring the Medicare Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium which for 2023 will be 65.90 for Part B. An important note that any IRMAA for the upcoming 2023 year will be based on your 2021 tax return....when SSA determines if any IRMAA is required they look a person's tax return from 2 year back. When 2024 Medicare premiums come out any IRMAA will be based on your 2022 tax return. Also, double check if that real estate sale or another sale was really reported on your 2021 tax return that you filed in 2022.

And regarding where you said you didn't signup for Part A or Part B, well, generally signup for Part A is automatic regardless of whether your address onfile with the SSA is in or outside of the U.S. And generally signup for Part B is "automatic" if have a U.S. address on-file with the SSA, but not automatic if having a foreign address.

https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly

https://hr.harvard.edu/files/humanresources/files/medicare_irmaa.pdf

I maintain my US address so that explains the auto enroll for Part B and my reported 2021 income of 100K increased money for Part B.

Pib · November 22, 2022

44 minutes ago, Pib said:

1. Yes

2. On "taxable" 401K/IRA. A Roth IRA is not taxable/reported on your tax return.

Whoops.....significant typo....I meant to say 2. Only taxable....vs 2. On taxable....

Pib · November 22, 2022

10 minutes ago, EVENKEEL said:

I maintain my US address so that explains the auto enroll for Part B and my reported 2021 income of 100K increased money for Part B.

For folks with a U.S. address, the SSA/Medicare folks does mail a person a letter/form approx 3 months before turning 65 saying you will be signed up automatically for Part B unless you complete the form declining the coverage and return it. You must have missed that form...or the SSA sent it to the wrong address....etc.

I'm not sure if that letter/form is sent to folks with an overseas address. It probably is although it may be worded a little differently from the letter/form that folks with a U.S. address get.

KanchanaburiGuy · November 22, 2022

Ironically, I just went through all this!

Turned 65 in September, 2022. For 90 days before your "eligible" date for medicare, and 90 days after, you are in a "Special Enrollment Period" where you can clarify exactly which of Medicare's coverages you want, if any. (Otherwise, you have to do it during their normal Annual Enrollment Period, and perhaps face penalties for delaying.)

In my case, this basically meant I had from the sometime in June until sometime in December, 2022, to tell them my preferences. BUT! When September rolled around and I became eligible to actually USE Medicare, I was automatically enrolled in both Part A & Part B, and $170 was deducted in both September and October from my Social Security payments.

But what I actually wanted was Part A only [hospitalization], and not Part B. Partly this is because Part A is free, anyway, so why not? (There are a few fairly rare exceptions where people have to pay for Part A, but they don't apply to me.) I didn't want Part B because it represents too big a chunk of my monthly Social Security payment........ and living in Thailand, I'm already nearly fully covered through my wife, and couldn't use it, anyway!

So, on November 8th, 2022, as they opened the doors, there I was, standing in the Scottsdale, AZ, Social Security office! (Started with Manila, and a nightmare scenario ensued, which is why I had to make the trip back home, instead!)

After positively identifying myself, I did a change of address to a new Scottdale address, then filled out the form DECLINING Medicare Part B. It all took less than 10 minutes (after d-cking around with Manila for 8 weeks, and making zero progress!)

The big surprise?

On Nov 10th, I got back a direct deposit of the money that had already been deducted in September and October......... $340 worth! The returned money arrived even sooner than I did! I was shocked! 555 And no Medicare money was taken for November, even though my office visit was only 1 week before the payment was due!

A surprisingly good experience, overall!

Cheers!

Edited November 22, 2022 by KanchanaburiGuy

taxout · November 22, 2022

Lucky you didn't get hit by a car etc in Scottsdale. Part A is actually pretty limited. Without Part B you'd still face crushing bills. Honestly, skip Part B only if you will never be present in the US. Otherwise it's like driving a car without liability insurance.

KanchanaburiGuy · November 22, 2022

3 hours ago, taxout said:

Lucky you didn't get hit by a car etc in Scottsdale. Part A is actually pretty limited. Without Part B you'd still face crushing bills. Honestly, skip Part B only if you will never be present in the US. Otherwise it's like driving a car without liability insurance.

LOL

Well, if having Medicare could prevent a car from ever hitting me.......... I would grab that coverage without a moment's hesitation!

But it doesn't work like that, does it.

So instead, it becomes a question of likelihoods; of risk assessment; of cost vs benefit.

For example: I paid auto insurance in the United States for about 40 years. During that time, I drove roughly the equivalent of 30 times around the planet ........750,000 miles. In those 40 years of being insured, I was in exactly ONE accident. And in that one accident, they hit me. So, it was THEIR insurance company that had to pay, not me!

And on the health side of things, yeah, I had a trip to the emergency room on 2014. And yeah, I saw a doctor to address a significant health issue in 1995. But again, the health insurance I had at the time didn't prevent these things. It just gave me a little payback against the tens of thousands of dollars I had already paid into insurance--------Tens of thousands of dollars that ultimately bought me exactly nothing.......... except a small bit of peace of mind!

LOL

So nah........ I'm not going to pay over $2,000 per year for insurance that I can only use when I'm in the States......... on the off-chance that one of those days........those days!......... will be the day when catastrophe strikes!

Now, get me insurance that prevents catastrophe? That literally prevents catastrophes from happening?........... Well that........ THAT!......... I'm all in for!

---------------

Personally, I've lived roughly 23,500 days, so far. I can say with absolute certaintly that at least 23,450 of those days........... were days when having insurance did me absolutely zero good!

So......... as I weigh my odds......... as I assess the risk of having only Medicare part A [hospitalization] and not having Medicare Part B for the relatively few days I spend in the United States each year.......... well, um, I've just gotta say........ I like my odds!

LOL

Cheers!

Edited November 22, 2022 by KanchanaburiGuy

Grandpaneal · December 11, 2022

On 11/21/2022 at 7:57 PM, Pib said:

Most people do "not" pay anything for Part A...it's free as long as you had 40 quarters/10 years of work of social security credits which I assume you did. It's Part B, repeat B, that cost $164.90 for 2023 (the basic premium)....it went down approx $5 from the 2022 premium.

The wife and I have Part A and B coverage.....we each pay zero for Part A and will pay $164.90/month for Part B in 2023.

https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/what-does-medicare-cost

Just saw this. You took SSA retirement before age 65? Or at 62? If so, SSA automatically enrolls you in Medicare A&B. You can submit the form to unenroll in B with FBU if they are handling your benefits. We went through this with my wife a few months ago. My sister in the States as well.

EVENKEEL · December 11, 2022

10 minutes ago, Grandpaneal said:

Just saw this. You took SSA retirement before age 65? Or at 62? If so, SSA automatically enrolls you in Medicare A&B. You can submit the form to unenroll in B with FBU if they are handling your benefits. We went through this with my wife a few months ago. My sister in the States as well.

I took SS at 62. I talked to the local office in my state of residency and she sent me the form to fax back to end Part B.

Pib · December 11, 2022

1 hour ago, Grandpaneal said:

Just saw this. You took SSA retirement before age 65? Or at 62? If so, SSA automatically enrolls you in Medicare A&B. You can submit the form to unenroll in B with FBU if they are handling your benefits. We went through this with my wife a few months ago. My sister in the States as well.

At 65. Medicare may "not" enroll you automatically in Part B if you have an overseas address on-file with SSA (you may or may not get a notice from Medicare saying such), but they do if you have a U.S. address. You do get enrolled automatically for Part A regardless of worldwide address. The wife and I with our Thailand address were not enrolled in Part B automatically. Now if the wife and I had started SS pension before 65 (which we didn't) maybe we would have got a notice of automatic Part B enrollment unless we decline.

The wife and I enrolled in Part B thru Manila at 65. Although Part B doesn't provide coverage outside the U.S. except in some very unique situations we needed to enrolled in Part B to maintain our Tricare military retiree/dependent medical coverage which does provide worldwide coverage. When a military retire and/or dependent turns 65 they will lose their Tricare coverage unless they enroll in Medicare Part B.

So, basically the wife I have have Tricare medical coverage when outside the U.S. like when living in Thailand and Medicare plus Tricare coverage when in the U.S. say we ever move back on go back for a vacation....our Medicare coverage kicks in the second we set foot on U.S. soil...no waiting period. Just how Tricare for Life and Medicare coverage work together.

Edited December 11, 2022 by Pib

Jingthing · December 11, 2022

I had an early SS claim using Thai address.

As stated above, I was automatically enrolled in Part A at age 65 but not Part B. To enroll in Part B, contact Manila FBU.

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