Process for signing up for US Medicare

[connda]

What is the process for signing up for US Medicare if one is already receiving US Social Security?

It seems some people must manually enroll while others are automatically enrolled. 

 

In my case, I do not want to be enrolled as I have health insurance that is good for life and I've no plans to return to the US to live but I currently receive social security payments.

So for those who have done this already, hows does the enrollment process work?

Edited November 9, 2016 by connda

[Thanyaburi Mac]

Seems to me I received Medicare Part A automatically, and also received a form where I declined Part B.

 

Should be some info here:  

 

https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-how-to-sign-up-for-part-a-and-part-b.html

 

and, for:  

 

Medicare Coverage Outside the United States. https://www.medicare.gov/Pubs/pdf/11037.pdf

 

Mac

[ballbreaker]

If you already receive SS benefits you should have received Medicare info in mail automatically at age 65.  If not 65 it should come in the mail when you reach 65.  As previous post states Part A is no cost and automatic, while Part B cost but you can decline Part B.

[CMBob]

Info already provided ought to provide your answer.

If you are never going back to the US, then obviously opt out of Part B when you can as that'll save you (currently) a deduction of about $1,060.00 per year from your social security benefits.  If, after you opt out, things change and you go back to live in the US, you can opt in again although at a higher cost per year (so much more per year that you weren't covered).  There are a lot of websites...including the Social Security website....that'll give you most or all the information you need.

If you will be going back to the US for any reasonable length of time during the year, then obviously make sure you're covered there under your current policy.  For example, some/many US policies require that, once you hit 65 and Medicare, you're required to have Part B or those policies won't cover the things Part B covers (and perhaps other supplemental items).  Your policy may be different....but the bottom line is to make sure you know how/if you're covered. 

Edited November 9, 2016 by CMBob

[thailand49]

You might be asking too late?  You got something like 3 months before your Birthday of turning 65 and 3 months after?  Whether you decide to return or not never burn your bridges?

[Grubster]

31 minutes ago, thailand49 said:

You might be asking too late?  You got something like 3 months before your Birthday of turning 65 and 3 months after?  Whether you decide to return or not never burn your bridges?

You can cancel part B at any time and will receive about 10% more SS if you do.

[dddave]

Though on Medicare, A & B, I recently enrolled in the Veterans Health Care system because I was eligible having served two years active duty while I was a Navy Reservist.  Because I was put on VA level 5, everything part B would provide, the VA would provide as well, so B was redundant.  I went to my local Social Security office and it took less than an hour to dis-enroll from B.

[akentryan]

I have Medicare A and B and a supplemental plan that covers about 70% of medical and medicine cost here in Thailand. Someone posted don't burn your bridges which I totally agree with. You will always have the option of returning to the USA for care. Two instances of note. My  cardiologist at the "best" hospital in Pattaya told me I needed two stents. I opted to have in done in the USA. My cardio doc in the USA said I didn't need stents but just a change in my medicine. That was 4 years ago and I am fine. This year my Pacemaker battery was dying so I opted to the Pacemaker replaced in the USA. That procedure in the USA cost over $60,000 but my out of pocket cost was airfare. Think about the quality of care you will receive here versus that back in the USA.. 

[Langsuan Man]

10 hours ago, thailand49 said:

You might be asking too late?  You got something like 3 months before your Birthday of turning 65 and 3 months after?  Whether you decide to return or not never burn your bridges?

 

As other have said, Part A is automatic and happens on your 65th birthday 

 

As far a the 3 months posted above that is not true.  You can opt in for Part B anytime after your become eligible but will pay a penalty of 10% higher premiums per year  that you wait.  This means that you technically have a full year before you must elect for part B without paying the penalty

 

In my case I received Part A automatically when I turned 65 but delayed applying for Part B until October (5 months later) thus saving myself around $500 in premiums.  Since I spend 8 months in Thailand ( Oct-May) it is vital for me to have full coverage for the time I am in the US

 

My retirement insurance provider has a "supplemental coverage" deal where if you continue with them they will cover 100% of your yearly Medicare deductible and 100% of your co-pays 

[thailand49]

10 hours ago, Grubster said:

You can cancel part B at any time and will receive about 10% more SS if you do.

The indication was the BM, was in the process of turning 65, or already?  In the last few month I myself have been getting tons of information in signing up. In that regard you have 3 months and 3 month after to decide whether you want it or not?  Then changes to other plans can only be done once at year (Part C,D,) which is around this time of the year. Not sure about full cancellations?

As to regards to S.S., also not sure you are correct especially if you are drawing S.S. before age of 65?  For my personal self that doesn't seem the case.  At the age of 62, when you decided to draw on your S.S. and told for example you are going to get 1600.00 per month,  when you are the age of 65 (Medicare) and you opt out of taking part B, your draw is going to be 10% more, there is no indication in everything I read. Maybe you can provide information to statement.

I just got a letter from S.S. stating my cost is 148.00 per month for Part B,  that amount is being deducted from what I am already getting from my draw on S.S.

Also, noted not everyone get automatically Part A-B, it depends how many years you have worked and how much contribution in your account in S.S.

[Pinot]

12 hours ago, thailand49 said:

You might be asking too late?  You got something like 3 months before your Birthday of turning 65 and 3 months after?  Whether you decide to return or not never burn your bridges?

 

You can opt out completely. If you decide to return to the US, you have 3 months to sign up again. I pay no medicare and collect the complete ss amount. 

[Grubster]

2 hours ago, thailand49 said:

The indication was the BM, was in the process of turning 65, or already?  In the last few month I myself have been getting tons of information in signing up. In that regard you have 3 months and 3 month after to decide whether you want it or not?  Then changes to other plans can only be done once at year (Part C,D,) which is around this time of the year. Not sure about full cancellations?

As to regards to S.S., also not sure you are correct especially if you are drawing S.S. before age of 65?  For my personal self that doesn't seem the case.  At the age of 62, when you decided to draw on your S.S. and told for example you are going to get 1600.00 per month,  when you are the age of 65 (Medicare) and you opt out of taking part B, your draw is going to be 10% more, there is no indication in everything I read. Maybe you can provide information to statement.

I just got a letter from S.S. stating my cost is 148.00 per month for Part B,  that amount is being deducted from what I am already getting from my draw on S.S.

Also, noted not everyone get automatically Part A-B, it depends how many years you have worked and how much contribution in your account in S.S.

If you have part B you can cancel it at any time. If you want to reinstate you will have to pay a percentage of the money you didn't pay when you were off it back before you are eligible again. I was only stating this as you need not worry that you will be stuck with it forever. You can't use it here but if very sick you could go back home and use it. The poster is fully insured and should deny or cancel.

[Neocon]

https://th.usembassy.gov/u-s-citizen-services/federal-benefits/medicare/

[taxout]

"You can opt out completely. If you decide to return to the US, you have 3 months to sign up again."

 

No  No  No. If you don't sign up for Medicare Part B in the period when you turn 65, then you can only apply during January-to-March, with coverage to start July 1. That is, if you move back to the U.S. on April 15, 2017, you won't be able to get Part B coverage starting till July 1, 2018. When it comes to Part B, there's no general exception to this rule for expats moving back to the U.S.

 

(There are some other exceptions to this rule, but they wouldn't normally apply to a retired U.S.citizen living in Thailand.)

 

[thailand49]

6 hours ago, Grubster said:

If you have part B you can cancel it at any time. If you want to reinstate you will have to pay a percentage of the money you didn't pay when you were off it back before you are eligible again. I was only stating this as you need not worry that you will be stuck with it forever. You can't use it here but if very sick you could go back home and use it. The poster is fully insured and should deny or cancel.

Maybe I'm not making myself cleared, or you are just not getting what is being said. I ask you Where you get the information if you decline Medicare coverage you get a extra 10%, I read the entire Medicare booklet and no where did it over state if you decline Medicare coverage A,B you get a extra 10%?  Again, people have to work a certain amount of years before they get A automatically, like myself, three months before I was to turn 65, I already got my card for A,B... those who don't have enough years can still get A,B, but have to pay for it and more.  Again, for example I started to collect early at 62,  told I was going to collect so and so,  never was I provided any information when I start to turn 65, if I decline Medicare coverage I would get 10% more.  How do you conclude? is it stated somewhere if you decline coverage you are going to get 10% more from what one is already collecting.

In all due respect I appreciate if you can provide where you got this information?  Not really concern whether one can cancel or not.  I also do not announce to the government where I live because it is none of their business.

[Grubster]

12 minutes ago, thailand49 said:

Maybe I'm not making myself cleared, or you are just not getting what is being said. I ask you Where you get the information if you decline Medicare coverage you get a extra 10%, I read the entire Medicare booklet and no where did it over state if you decline Medicare coverage A,B you get a extra 10%?  Again, people have to work a certain amount of years before they get A automatically, like myself, three months before I was to turn 65, I already got my card for A,B... those who don't have enough years can still get A,B, but have to pay for it and more.  Again, for example I started to collect early at 62,  told I was going to collect so and so,  never was I provided any information when I start to turn 65, if I decline Medicare coverage I would get 10% more.  How do you conclude? is it stated somewhere if you decline coverage you are going to get 10% more from what one is already collecting.

In all due respect I appreciate if you can provide where you got this information?  Not really concern whether one can cancel or not.  I also do not announce to the government where I live because it is none of their business.

If you could please reread my post you will find I said you can cancel part B at anytime and get around 10% more in SS benefits, you cannot cancel something you do not have. In the end I said the original poster should deny part B or cancel it if he has already been unknowingly signed up for it which happens, because he has full insurance. You on the other hand have not had part B and will probably have to pay approximately 10% if you decide you want it when you qualify for it. I am not sure in your case as I had part B from the start. Sorry for the misunderstanding. You can google SS and find the answer for your case.

[connda]

Interesting.  I checked my mailbox today and there it is.  My Medicare Part B application form.  I guess they send this out to those collecting Social Security.  Cool. 

[taxout]

If you cancel Part B, then they stop deducting Medicare Part B premiums from your Social Security benefit, so your NET Social Security benefit increases. This year, the Part B premium varies from about $108 to $120 per month, depending on your situation. Whether that's more or less than 10 percent of your Social Security benefit depends, of course, on the amount of your particular benefit.

[thailand49]

14 hours ago, Grubster said:

If you could please reread my post you will find I said you can cancel part B at anytime and get around 10% more in SS benefits, you cannot cancel something you do not have. In the end I said the original poster should deny part B or cancel it if he has already been unknowingly signed up for it which happens, because he has full insurance. You on the other hand have not had part B and will probably have to pay appimately 10% if you decide you want it when you qualify for it. I am not sure in your case as I had part B from the start. Sorry for the misunderstanding. You can google SS and find the answer for your case.

 

I have read over and over your reply and did so again after you respond. You still have not answer the question nor provided the area to confirm you statement. There is nothing again nothing stating in the S.S. website nor anything in the Medicare information booklet stating " if you do not sign up or cancel Part. B.

Here is my actually situation regarding collecting S.S. and now collecting to show that you do not get 10% more in the collection of your S.S. if you do not sign up for Part B.

When I turn 62, I went down to the S.S. office and my monthly was going to be 1650.00 per month.  Early this year went again to the office question about Medicare, told  since I qualify I will get a card automatically which I did in August to be effective Nov 1st, there is a form in the packet if you do not return you will be sign up for Part B, and charged accordingly.  When I was at the office told the amount for Part B, is around 105.00, which one can pay in different ways. My choice was for them to just deduct it from my current amount of 1650.00.

Based on your post if you do not sign up or one plan to cancel Part B... you will get 10% more in your S.S. benefit, so based on my 1650, if I  cancel or didn't sign up my benefit amount will be 1650.00 plus 10% =  (165.00)  1815.00?  That is how you are coming across on the post to me at least?

Just because you do not sign up or cancel and they don't deduct the part B, amount from my benefit 1650.00 doesn't mean I'm getting 10% more in my benefits?  Yes misunderstanding if this is what you meant?

[Langsuan Man]

And let's not forget that your Part B Medicare Premiums can go up considerably if your income goes up, which it most certainly will if you have any IRA's or 401K retirement plans , when your Required Minimum  Distributions, (RMD's) kick in when you hit 70 1/2.  

 

source: https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html

 

Also remember that Medicare uses a different formula to determine your income, they have what they euphemistically call Modified Adjusted Gross Income (MAGI)  which counts income that may be tax free for income tax purposes but since Medicare premiums are not "taxes" can be adjusted in Medicare's favor 

 

see: https://www.irs.com/articles/what-modified-adjusted-gross-income

[Grubster]

8 hours ago, thailand49 said:

 

I have read over and over your reply and did so again after you respond. You still have not answer the question nor provided the area to confirm you statement. There is nothing again nothing stating in the S.S. website nor anything in the Medicare information booklet stating " if you do not sign up or cancel Part. B.

Here is my actually situation regarding collecting S.S. and now collecting to show that you do not get 10% more in the collection of your S.S. if you do not sign up for Part B.

When I turn 62, I went down to the S.S. office and my monthly was going to be 1650.00 per month.  Early this year went again to the office question about Medicare, told  since I qualify I will get a card automatically which I did in August to be effective Nov 1st, there is a form in the packet if you do not return you will be sign up for Part B, and charged accordingly.  When I was at the office told the amount for Part B, is around 105.00, which one can pay in different ways. My choice was for them to just deduct it from my current amount of 1650.00.

Based on your post if you do not sign up or one plan to cancel Part B... you will get 10% more in your S.S. benefit, so based on my 1650, if I  cancel or didn't sign up my benefit amount will be 1650.00 plus 10% =  (165.00)  1815.00?  That is how you are coming across on the post to me at least?

Just because you do not sign up or cancel and they don't deduct the part B, amount from my benefit 1650.00 doesn't mean I'm getting 10% more in my benefits?  Yes misunderstanding if this is what you meant?

OK #1 I said about 10%.   #2    I said if you "cancel" part B. You don't have part B so you cannot cancel something you do not have can you?  If you don't have part B and you want it you are going to have to pay for it. If you deny it you will not have to pay for it. 

             I was only saying this as I have met a few guys here that had part B, I told them that and they cancelled part B and got about 10% more SS per month.  Turns out the amount varies by income as shown in the post above.

[thailand49]

15 hours ago, Grubster said:

OK #1 I said about 10%.   #2    I said if you "cancel" part B. You don't have part B so you cannot cancel something you do not have can you?  If you don't have part B and you want it you are going to have to pay for it. If you deny it you will not have to pay for it. 

             I was only saying this as I have met a few guys here that had part B, I told them that and they cancelled part B and got about 10% more SS per month.  Turns out the amount varies by income as shown in the post above.

Thanks bye!  

[Pib]

Maybe just best to say if not paying the Part B premium which is currently $121.80/mo for most people starting Part  B in 2016 (probably smaller at around $104 if you had been on Part B before 2016), the net amount of SS pension arriving their bank account each month will be higher since there is that one less deduction.  But a person's total/gross SS pension "before any deductions" such as Part B, taxes, etc., does no change.  

 

If the person was getting approx a $1,000/mo gross SS pension with about $900 net arriving their bank account then yea their total take-home pay would increase around 10%.  Any time you can get rid of some deduction happening to a payment, then the take-home (net) pay increased.   The average gross SS pension payment as of Sep 16 was approx $1,300.

 

But of course that deduction eliminated came at a cost of no Part B medicare coverage if able to use the coverage which generally means getting the care "within the U.S." unless a military retiree where the Part B coverage allows you to retain Tricare  past 65 at no cost and Tricare for Life can be used outside or inside the U.S.  (e.g., worldwide like here in Thailand).

 

And if needing to sign up for Part B at a later point in your life because you need the coverage, you will pay a higher monthly premium of a 10% per year premium penalty for each year you could have had Part B but didn't signup....that premium penalty can add up to a lot after a few years of not being enrolled in Part B.   Say you delay sign-up 5 years and not start it till 70 when you could have started it at 65....well, you premium will be 50% higher for life than those who started at 65.

 

The same type of premium penalty can occur if you were on Part B, but for some reason not meeting one of Medicare's "Special Conditions" dropped Part B for a couple of years and then want to start again.  

 

And don't forget the sign-up windows....a person generally can not sign-up just whenever the mood strikes them.

 

 

[taxout]

Remember, too, that if you decide to skip Part B, then heading back to the States for even a visit will be pretty risky, given the extraordinarily high charges for medical care paid by those without insurance in the U.S. One illness or accident and a great chunk of your savings could disappear. Yes, you'll presumably have the free Part A coverage, but when you look at the fine print, much of the real coverage is under Part B. You need both if you're ever going to step foot in the U.S. again.

[avvocato]

On 11/10/2016 at 5:53 AM, akentryan said:

I have Medicare A and B and a supplemental plan that covers about 70% of medical and medicine cost here in Thailand. 

Good sir, akentryan. Can you give me some information on your supplemental plan that covers up to 70% of costs in Thai. Who is it with? How does one apply? Thank you.

Edited November 12, 2016 by avvocato
Mispell

[14greg]

OP posted " I have health insurance that is good for life ", I also have healthcare for life, this is how that goes, Until age 65 employer is my primary insurance when reach age 65 medicare becomes primary covering 80%, employers insurance is now secondary or supplemental coverage 20% less copays all of which gives me no coverage in thailand   This is how most insurance plans work in the states .   In 2017 my former employer is switching to a "medicare advantage" plan that will give me emergency coverage around the world, as long as I maintain a physical residence in the States   

[Pib]

Yea, my sister works for county school system where even if  you are still working for them when you turn 65 the schools system's medical coverage plan changes from 80% reimbursement to 20% reimbursement because the person is expected to sign up for Medicare Part B. It's just the medical plan the county school system has bought for its employees as it lowers the cost of medical benefits they provide to employees.   Yeap, all kinds of medical insurance plans provided by employers and some plans change dramatically when a person turns 65.

[gk10002000]

On 11/10/2016 at 5:42 PM, Langsuan Man said:

And let's not forget that your Part B Medicare Premiums can go up considerably if your income goes up, which it most certainly will if you have any IRA's or 401K retirement plans , when your Required Minimum  Distributions, (RMD's) kick in when you hit 70 1/2.  

 

source: https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-costs.html

 

Also remember that Medicare uses a different formula to determine your income, they have what they euphemistically call Modified Adjusted Gross Income (MAGI)  which counts income that may be tax free for income tax purposes but since Medicare premiums are not "taxes" can be adjusted in Medicare's favor 

 

see: https://www.irs.com/articles/what-modified-adjusted-gross-income

Thanks for the rough idea on the medicare B costs.  I will have lots of MAGI that will be different from my AGI since I have lots of muni funds and muni bonds.  But I am sure I will be keeping my income below 85K.  Now I have a better idea of how I will handle my IRA distributions or conversions.  I thought Roth IRA distributions are NOT counted in the MAGI but I will double check that;

[Pib]

Those are 2016 premiums...new and improved (and higher) premiums for 2017 just around the corner can be found here:

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2016-Press-releases-items/2016-11-10-2.html

 

Roth IRA distributions are not counted.

https://www.linkedin.com/pulse/roth-withdrawals-dont-count-medicare-part-b-premiums-david-s-rodgers