Toni Says

by Toni King


Medicare Rule…Married VS Domestic Partner And Delaying Medicare Part B


Toni:

My problem is different than most couples because now I am finding out that my company’s group health plan is not paying for ANY Medicare Part B medical expenses since I am not married but am in a domestic partner relationship. We have been together for over 25 years but never officially married.  Samuel is 70 and I am a 58-year-old female who now must learn the maze of Medicare.

            Sam 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.  He 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 a married couple because we do not have a marriage license. 

            Now he needs to enroll in Medicare Part B and with him being 70 if he doesn’t do this correctly the penalty will be over 5 years and from what I have read in your articles is that this could be a large penalty forever.  The bottom line is …We need HELP!!  Thank You Sarah from Las Vegas, NV

Sarah:

This needs to be a rush job! Sam needs Medicare Part B immediately!

            This is a new question that I had never thought about and everyone needs to know the rules of Medicare regarding delaying Medicare Part B, when there is an unmarried domestic partner situation (same sex or opposite sex) and they receive health insurance through their partner’s employer. 

            Always discuss delaying your domestic partner’s Medicare Part B with your company’s HR department about what is in the company’s handbook regarding unmarried domestic spouse Medicare rules.

            Sarah you are in the middle of the maze of Medicare!

            The size of the group makes a difference. When there are under 100 employees on your unmarried spouse’s group health insurance plan, you should generally not delay the non-working domestic partner or common law spouse’s Part B. When there are over 100 employees, then consult your benefits or HR department about if your domestic partner can delay their Medicare Part B without receiving a late penalty when they need to enroll in Medicare Part B at a later date.

            I have written about the Special Enrollment Period and having the Social Security for titled “Request for Employment Information” filled out by your HR or office manager.  This should be done ASAP and Sam could have his Medicare Part B with an effective date of  November 1.

            Very Important… Sam will have to take the form down to your local Social Security office, meet with a Social Security agent in person and get copies of everything.

            Don’t mail it to Social Security or put it in the drop box.  Always meet face to face with the Social Security person!

            There are specific Medicare rules when changing from a Medicare Advantage plan to a Medicare Supplement.  For help, call the Toni Says Medicare Hotline at 1/844-250-8664 or email info@tonisays.com.

            Toni King, author of the Medicare Survival Guide® is giving a $5 discount on the  Medicare Survival Guide® Advanced book to the Toni Says Medicare column readers at www.tonisays.com.