Delay in Part B enrollment triggers Medicare maze

Dear Toni: I am finding out that my company’s group health plan is not paying for any Medicare Part B medical expense since my “husband” is a domestic partner. We have been together for over 25 years but never officially married. Richard is 72 and I am a 58-year-old woman who now needs to learn the maze of Medicare.

Richard has serious health issues with two stents and recent back surgery, which is costing us thousands of dollars because my company’s group health plan is not paying for his doctor’s care. Richard has never enrolled in Medicare Part B because I have always been the “working spouse.” I am discovering that the company’s self-administered group health plan does not recognize “domestic partners” as married couples.

Now, Richard needs to enroll in Medicare Part B, and with him being 72, if he does not do this properly, the penalty will go back seven years. From what I have read in your articles, this could be a 70 percent or 80 percent lifetime penalty. — Gabby, Dallas

Dear Gabby: Enrolling in Medicare Part B for Richard is a rush job! You are now in the maze of Medicare, and Richard needs Part B ASAP.

The working partner should always contact their company’s health insurance benefits administrator to find out its policy regarding unmarried domestic partners and Medicare rules. This should be done before your domestic partner turns 65 so you can determine if it’s wise to delay Part B enrollment.

Richard will need to take the two Social Security forms — CMS L-564, “Request for Employment Information,” signed by your employer’s human resources department, along with CMS 40-B, “Application for Medicare Part B” — to his local Social Security office. He could have his Medicare Part B starting the first of the next month.

It is crucial that Richard writes “special enrollment period” across the top of each form that he is turning in with Social Security. This will keep him from receiving the dreaded Medicare Part B penalty.

During Toni Says Medicare consultations, we advise clients to meet with a Social Security representative in person for the added protection of being sure that the forms are received properly. And always make copies of everything filed with the Social Security office.

Toni King is an author and columnist on Medicare and health insurance issues. If you have a Medicare question, email info@tonisays.com or call 832-519-8664.