My parents, aged 92 and 95, worked in the school systems their entire lives, paid some SS, are now retired with Medicare and TRS United Health Care/Medicare Advantage, which apparently has been paying for their previous hospital stays. Both are in AL now and we have just discovered that neither parent has Medicare Part A coverage - only Medicare Part B. Apparently Part A is necessary to qualify to receive coverage from Hospice. We cannot figure why they don't have this coverage and how, if possible, they can get it at their ages. I'm not even sure where to start. Any suggestions would be appreciated.
Source: https://www.medicare.gov/basics/get-started-with-medicare/sign-up/when-does-medicare-coverage-start#:~:text=You%20can%20sign%20up%20for,Health%20Savings%20Account%20(HSA).
You can contact a broker to help you figure things out.
At the bottom of the page, the State Health Insurance Assistance Programs (SHIPs) agents are usually good. They go through training and are fairly objective (and free!).
Also Medicare.gov has real humans you can talk to by phone.
Is the issue possibly they didn’t sign up ages ago because they didn’t have 40 quarters each? They were on teachers retirement system of some sort so did not pay into FICA? And maybe…. maybe they just continued to let it slide as they got in an Advantage Plan and never bothered to look further as that seemed to work? Was this it?
If so, you may have to find out exactly what their work history is from SSA. Yiu would need to become their representative payee for SSA as SSA….. wait for it… does NOT recognize POAs…. so for even more fun! in all this, the SSA rep payee will need to be done. But whatever. If they have worked enough SS quarters, they can become Part A enrollee at a late date, but will have to pay a premium. It’s called a voluntary enrollment. With 30-39 quarters it’s $278 a month; with 29 or fewer quarters it’s $506 a month. As they are married, I think only 1 of them needs to qualify (so mom could have been a stay in the home type of wife). But the $ amount for the premium is for each of them. I don’t think there is any type of waiver available to get around this either. Yeah it sucks. Bottom line it is expensive but realistically, at 90+, they cannot ever find any other health insurance coverage.
As a side note, hospice pays on the average right under 5K a month, so having Part A is definitely worthwhile.
From: ElizabethAR37
You're SO knowledgeable about this stuff! People who worked in government or some other types of jobs were part of different retirement systems which complicates matters. (My spouse was in a law enforcement retirement system for 10 years and cashed out when he changed fields--not the best move but made sense to him at the time.) Hope it's O.K. to ask a question of you rather than trying to search out the answer on the SSA website: can spouses become representative payees for each other in advance of need? My spouse and I are both competent at this point, but there may come a time when one of us isn't.
Until now I thought part A was a given and you paid a premium for part B. I know when DH turned 65, his Company health insurance went to a supplement and we had to have part B. Actually, since we started taking SS at 62, we received our Medicare card automatically at 65 with A&B already on the card.
Learn something every day.
Good Luck and update. We learn from others.
WHAT DOES COVER THIS for your parents? You list what their insurance is. I would assume some part of their insurance covers hospitalization, and that would be the part that would cover Hospice for them as well.
I will tell you this. Don't expect much out of hospice. In the last years it has gone from a mission to a hedge fund mess. They are all for profit and they give you very little. I recently had a friend, end of last year, pass with Hospice. You get about 2-3 bath assists a week from an aid that is in and out like greased lightening. You get an RN visit once a week. She will take your BP and sit at bedside a second. You get a call from a Social Worker who knows almost nothing and a call from a clergy who hopes you aren't religious at all. That's about it, along with that nifty little bottle of morphine.
Just saying, if you are counting on a lot from what was to me the miracle of Hospice? It is over. And the current one is charging Medicare a massive chunk to do nothing much at all. IMHO.
I'm sorry you've had such a negative experience with Hospice, however, my father is getting the most excellent care imaginable from them here. They are always a phone call away when I have questions or need anything for him. They've brought in numerous oxygen machines, air tanks, wheelchairs, walkers, toilet seats, nebulizers and medications. Provide baths, nursing care, chaplain and social worker visits and always seem to take their time when visiting with him. The head of the organization accepted my father pro-bono so to me, they are amazing. I know there are several Hospices here in Lubbock, so maybe, like everything else, there are good ones and bad ones.
Blessings to you and yours.
I can now quit worrying about working with the SS office and concentrate on loving my mother through this difficult journey.
Hope this info helps someone else out there with the same problem...
Blessings to one and all.
TRS really seems unprepared for dealing with the nuances of health care beyond straightforward hospitalization & traditional doctor billing. What’s so maddening is I don’t think you have a choice to opt out of TRS….. you work for the State of TX, ya have to do its retirement system.
FWIW this year 2024 means all “Baby Boomers” 1946 - 1964 have hit age 60. The “silver tsunami” is real.
And for anyone reading this, please pls pls find out if you & your fam have the 40 working quarters to get Part A Medicare for free or have to instead budget for either the $ 278 or $506 every month in perpetuity to be eligible for Part A (I cannot imagine how difficult this will be for budgeting for so many); OR do the research to find a Medicare Advantage Plan that covers all the Part A benefits (like hospice) at the same range that Original Medicare does.
IF you have to pay the $506 every month plus the everyone pays Part B of $175 every month, thats a solid chunk automatically out of your SSA retirement income.
Glad everything got straightened out.