Ronni still calls me a "monthly columnist" but that frequency is currently a fiction. These days -- through November -- I'm employed working to pass an initiative to replace the death penalty in California with life in prison without parole. After the election, I hope to resume more active contributions on our subject here!

Jan,

What an excellent post! I have never even considered this scenario, and would love to talk about this issue on my Medicare blog. May I share your story with my readers (in my own words, of course)?

As an insurance agent dealing with Medicare every day, I see some issues with your statements. (I am also getting my health insurance through my partner.)

When you are turning 65, it doesn't matter if you have been covered by a group health insurance plan - or if you haven't had health insurance for the last 20 years. You get your Medicare no matter what your health or your past insurance coverage. The question about group health coverage is just a survey question.

Additionally, you don't pay more or less for Medicare if you are married or not.

HOWEVER, if a person in a same-sex relationship is a stay-at-home mom or dad, that could be a problem. That's because a person must work at least ten years and pay Medicare taxes to qualify for Medicare - unless that person has been married. A wife or husband who never works outside the home will get Medicare through her or his spouse.

NOT TAKING MEDICARE PART B at 65: I am looking right now at the form a person fills out to apply for Part B when they have had employer group coverage beyond their 65th birthday. This form is filled out and signed by the employer stating that the person had group coverage and did not need Medicare Part B. This form allows a person to get his/her Part B without penalty or delay.

The form refers to "employee" and "claimant", but does not mention "spouse". And yet, a spouse can remain on her husband's employer plan beyond age 65 and uses this form to apply for Part B. So I think it doesn't really matter whether or not a person is "married" - they just need to prove they had employer group health coverage.

DOMA stinks (thanks a lot, Bill Clinton!, but I don't think it affects a person in terms of Medicare - unless a person was a stay at home mom or dad and did not work 40 quarters/10 years to earn Medicare on their own.

Thanks so much for this Jan.

So much of what a person encounters when trying to understand and sign up for Medicare is hard to understand or downright absurd! It's no wonder so many people go with the basic Advantage plans (which offer no advantages). The path of least resistance is easiest for this vital but dreadful maze of coverages. I don't lie on my tax return and I don't want to lie elsewhere, so I appreciate Jan's predicament.

Okay, I get the picture now.

You had to take Medicare when you turned 65 because your partner's employer coverage would not be recognized after you turned 65 - because the feds don't recognize your marriage.

Sorry, my reading comprehension isn't what it used to be.

My health insurance company mandated I apply for Medicare when i turned 65 because it then becomes a supplement to Medicare.

I can see one issue with the employer group insurance - it has nothing to do with a late enrollment penalty - if you answer yes and it's based on active employment and the employer has more than 20 employees, then Medicare pays second when a person has both the employer insurance and Medicare. That might be where the legal issue comes in - a employer policy that is not an employer policy. So answering yes could mean Medicare wouldn't pay unless the group policy paid first.

There are SHIP (State health insurance assistance program) counselors in every state, and they can help with these Medicare issues. (Such as an explanation of Part A - which covers hospital and skilled nursing home - and Part B - which is doctor and therapy and lab charges and secondary coverage by retiree policy or a Medicare Supplement.)

If a person is self-employed he/she has an individual insurance policy. If a person retired before 65 they would get an individual health insurance policy (unless they are lucky enough to have access to their former employer's insurance). These people must use Medicare as their primary insurance when the turn 65.

If a person works for a company with fewer than 20 employees, they must use Medicare as their primary insurance when they turn 65.

Using employer insurance as a supplement to Medicare might be more expensive than getting a true Medicare supplement and Part D plan. Compare the costs and coverage to be sure you're not paying too much by keeping your employer coverage as a supplement to Medicare.

In Jan's case, it sounds like her partner works for a big company with good health insurance. The cost for this coverage might be less than paying for Medicare plus a supplement plus a Part D plan. But Jan is not allowed to stay on her partner's employer health plan because she is not considered married by the federal government. (Well, she can stay on it, but would be penalized for not enrolling in Medicare at age 65.)

So Jan doesn't have the option provided to people whose marriage is recognized by the federal government. She is required to move over the Medicare when she turns 65, even if it will be more expensive than staying on her partner's employer plan.

There is lots of helpful info in the discussion above, but I'm still confused! I called Social Security to enroll in part A only because I'm retiring and it seemed the best option to go on my partner's plan. When I told the person on the phone that, more questions and long pauses ensued. Eventually, after checking, she told me I could not opt out of part B without penalties because my partner and I are NOT the same sex, just not married. She said if we WERE the same sex, the domestic partnership would be recognized, but since we are not, I can't say I'm covered by his insurance, even if I am. If I don't want my insurance costs to rise 10% each year becaue I'm not using B, I have to enroll.
Yes, I'm well aware we could marry if we want to, but why should the feds feel they must coerce us? Not going to work, but now I need to revisit how I can make my economy work with my chronic health issues adequately covered.