All of us, when we turn age 65, are supposed sign up for Medicare. But for employees covered by employer health plans, the only requirement is to sign up for Part A (Hospital Insurance). No need to sign up for Part B (Medical Insurance) because that is being provided by the employer plan. When the employee retires, Medicare provides a special enrollment period during which the employee can sign up for Part B on basically the same terms that would have been available at age 65. How do these rules impact RDPs (and same-sex spouses) who are covered on their partner’s plan? If you are approaching age 65, you need to know the answer to this question.
Medicare coverage under Part B requires payment of a premium. It seems silly to have to pay a premium to Medicare for medical insurance when you are already covered by another plan linked to your partner’s employment. But here’s the problem. If you fail to sign up during the “initial enrollment period” made available at your 65th birthday, you cannot sign up again until the next open enrollment period. The “initial enrollment period” ends three months after you turn age 65. If you miss this period, you can sign up during a subsequent open enrollment period. The periods are from January 1 through March 31 each calendar year. But here’s the kicker. If you wait and sign up during the open enrollment period at age 66, you will pay a 10% premium penalty. And that penalty will increase 10% for each year that you wait.
For the employee who is covered by the employer plan there is a special rule regarding enrollment. Employees can sign up at any time during employment or 8 months after the employment ends or the employer provided benefits end. This is known as a “special enrollment period.” Spouses of the employee are also entitled to this “special enrollment period.”
But under DOMA (Defense of Marriage Act), a same-sex spouse (or Registered Domestic Partner or just a domestic partner covered by the health plan) is NOT entitled to this “special enrollment period.” That means there are TWO problems that same-sex spouses and partners covered by their partner’s health plan face. One, if your partner retires or benefits from the plan cease at any time other than January through March of a given year, you will be without coverage and unable to sign up for Medicare until the following January. And, for each year that you wait to sign up past age 65 you pay a 10% penalty.
And so, even if you are currently covered by a good health plan past age 65, you might consider signing up for Medicare just to be sure coverage continues. And by the way, if you do sign up and then someone from the local Social Security office calls to say you don’t need to because you’re covered by an employer plan, get that in writing. True story: This happened to a 65 year old partner in Palo Alto, California. Stanford Benefits said she did not need to sign up, but she thought otherwise and so did. The Social Security folks unenrolled her, claiming she didn’t need to sign up because she was covered by the Stanford plan. WRONG! And so they re-enrolled her retroactively to make it effective.
Something is really wrong when the people who administer a program don’t understand how it works in the lives of same-sex couples. And, the falling of DOMA will not completely cure this problem. Many employers in non-recognition states provide domestic partner coverage. Getting rid of DOMA won’t help those employees and their partners at all. We need to change the benefit rules at the federal level to take into account the fact that there are lots of same-sex couples in this country that Congress has ignored for way too long.
