Dad Refuses to Sign Up for Medicare

[justplucky]

My dad, who will turn 65 in December and is in good health, refuses to sign up for any sort of health insurance. Both of my parents have stuck their heads in the sand about the situation, but my mother admits it is a problem.

I'm trying to understand the worst case scenario impact to their financial situation if he should have a medical event. He is retired and is collecting Social Security, so my understanding from basic research is that he will be automatically enrolled in Part A. That should cover the emergency parts if he has a medical event (they can easily afford the Part A deductible), but as we all know, things like strokes don't just require limited-time care. They have a paid-off house, but little savings. Together they have a solid middle-class retirement income.

My main concern is I don't want to end up financially supporting my mother if my father dies before her. I know I am not legally obligated to do so, but I have personal moral issues with not making sure she has a safe place to live, enough to eat, etc.

Am I worrying too much? Is there a way my mother could sign my father up for the additional parts of Medicare without his permission?

[Kathryn K.]

What reason does your dad give for not signing up for Medicare? I take it he's uninsured currently? Has he always been uninsured? Have you said anything to him similar to what you said here about your mom potentially being left in a bad position?

[justplucky]

My dad distrusts the medical profession and thinks they're all just out to make money. He's way into right-wing radio, so I'm guessing that distrust/paranoia is related to that. I am going to visit them next weekend and plan to have an earnest conversation about this potentially putting Mom in a bad place, and me as well by proxy. It would be helpful if I could paint a picture with the worst case scenario.

He lost his job and has been uninsured for several years now. He even had an emergency room visit due to chest pain during that time, and it was not wake up call. The hospital waived the bill because of his lack of insurance.

[Candace]

He's collecting Social Security per the OP, so perhaps he doesn't hate all aspects of the government. Perhaps you can draw something of a relationship between SS and Medicare? Those two programs, together, are supposed to comprise the safety net he can use to protect his wife and you.

[WhiteTrashCash]

People with that kind of mindset usually respond to stories better than explanation. Try sharing some personal stories from people about falling victim to medical issues as seniors especially if you can find short video clips with interviews and graphics. Try finding people like your father -- conservative everyman types -- who might remind him of himself. That might make a difference.

[jim555]

I would let him know that if anything happens it is on him.  He has made an adult decision not to go on Medicare, now he will live with the consequences.

[GizmoTX]

If he’s late signing up, his premiums will be permanently higher than if he signed up on time.

Maybe he thinks that since the one bill was waived, they all will be in the future.

[Altons Bobs]

Part B Late Enrollment Penalty: https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-late-enrollment-penalty

Part D Late Enrollment Penalty: https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/part-d-late-enrollment-penalty

He should be aware of the above, if not, you make him aware of them. There are tons of $0 plans out there that he can get to not have to pay a lifetime penalty, but he does have to pay for Part B, unless he qualifies for Medicaid then the state will pay the premium for him.

[Another Reader]

He is already on Social Security, so Part A, which is free, is automatic.  Part A pays the hospital bill.  It does not pay any doctor bills.  A couple of months before he turns 65, he will get a packet from Medicare.  It includes a Medicare card with a membership number.   If he wants to skip Part B, which pays for the majority of doctor bills, he has to sign a form and mail it back.  If he does not do that, the premium for Part B will automatically be deducted from his Social Security payment, beginning with the month he turns 65.

There is a "Welcome to Medicare" pamphlet in the package.  It's online, and I suggest you read it before you talk to him.  In addition to Part B, there is drug coverage under Part D, which has to be purchased.  It's voluntary.  There are also Medicare supplement policies, called "Medigap" policies.  They pay most of what Part B does not pay.

He is probably not a candidate for Medicare Advantage, which has lower premiums, because of high out of pocket expenses in some circumstances.

In addition to reading the Medicare information, you may want to have a look at some of the videos on SeniorSavingsNetwork.org.  The guy that produced those videos sells the various supplement  plans, but the videos are very helpful in understanding how the various parts of Medicare work.  It's in your and your mother's best interest to understand Medicare to minimize the financial damage from your father being uninsured can do.

[CrustyBadger]

I'm trying to understand the worst case scenario impact to their financial situation if he should have a medical event. He is retired and is collecting Social Security, so my understanding from basic research is that he will be automatically enrolled in Part A. That should cover the emergency parts if he has a medical event (they can easily afford the Part A deductible), but as we all know, things like strokes don't just require limited-time care. They have a paid-off house, but little savings. Together they have a solid middle-class retirement income.

My main concern is I don't want to end up financially supporting my mother if my father dies before her.  I know I am not legally obligated to do so, but I have personal moral issues with not making sure she has a safe place to live, enough to eat, etc.

Am I worrying too much? Is there a way my mother could sign my father up for the additional parts of Medicare without his permission?

I don't think that your dad signing up for Medicare, or not, will actually have much impact on whether you will need to support your mom if he dies before her.

Are you concerned that in the event he has a stroke, he will need long term nursing care which will eat up all their assets?   Because Medicare actually won't pay for much long term nursing care.   So him having Medicare won't help that situation.

What will you mother have for income, if your dad passes away?  I think that is what you should be focusing on: her pension or beneficiary's portion of his pension; her Social Security (or portion of his) etc.

[Awesomeness]

My dad is 84 and his health is failing fast. He had his left foot amputated and went to rehab. During all this we discovered he had Humana Medicare which is not Medicare. It’s a private plan. Nightmare to deal w as they didn’t give him adequate time in rehab. It was a constant battle of denial and appeals.  From reading the other thread about a forum members father having a stroke I knew to tell them no when they called us siblings asking for money. All they needed was a form form the hospital to resubmit to the insurance but they’re too lazy to do it. We had to fight them to do their job. We held strong and told them to fix it and get their money from the insurance or bill my dad and he’d pay what he could from his SS income. They were bullies, it was nuts. Of course they fixed it the next day.

Anyway it’s a nightmare. My brother got him switched to real Medicare in the Medicare.gov website and on a prescription plan to help w his meds. Much better coverage.  Sorry I don’t know more details on which plan or the cost.

Just wanted to say hope you can get him to sign up but there is a big difference in these plans. We always thought our parents had government Medicare but apparently he just picked the cheapest thing he could find. Not sure he even knows what he bought. I’m sorry if this is common knowledge, thought it would be worth mentioning just in case.

To help you w worse case scenarios, we did some shopping for assisted living and full time nursing homes. His income is about 2250 which would qualify him for Medicaid. Also he did serve briefly during wartime in the Navy and that qualified him for a VA program that would add about 1800$ monthly to his 2250 income to pay for either home.   We did find some nice places for 3-4 grand a month.  North Texas locations. We hope he will end up in a nice assisted living facility my sister found, it’s non profit and they mentioned many times how they work w patients budgets and lower their fees.

My sister is the saint and helped find all these programs for him. So many services out there to help the elderly. And yeah my dad is stubborn too. Complains about everything to everyone. He’s the classic grumpy old man.  He’s finally opened his mind for help now that his health is so poor. Unfortunately it makes it difficult for the kids when you don’t have your affairs in order.  Lessons on what not to do to our own children. 

Good luck.

[RedwoodDreams]

Part B Late Enrollment Penalty: https://www.medicare.gov/your-medicare-costs/part-b-costs/part-b-late-enrollment-penalty

Part D Late Enrollment Penalty: https://www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/part-d-late-enrollment-penalty

He should be aware of the above, if not, you make him aware of them. There are tons of $0 plans out there that he can get to not have to pay a lifetime penalty, but he does have to pay for Part B, unless he qualifies for Medicaid then the state will pay the premium for him.

He absolutely should sign up when he's first eligible. As noted above, if he changes his mind later, he will pay MORE for the same plans for the rest of his life if he doesn't enroll when he's first eligible.

Medicare Part B covers doctors, tests. Mine costs $134/month and is taken from my monthly SS payment automatically. Medicare Part B only covers 80% of doctors, tests, so you have to also buy a supplemental (medigap or medicare advantage) policy (that's private insurance, but all plans must meet Medicare govt standards) to cover the other 20% unless you're independently wealthy and don't have to care about that. Because there's no concept of out of pocket maximums with Medicare, 20% can be a huge amount of money if you have a health crisis.

Medicare Part D private plans cover prescriptions, though I think some Medicare Advantage plans might also cover prescriptions.

It's a lot of info to sift through but very (VERY!) important--not having prescription coverage means you're paying out of pocket for medications. Not having Part B coverage means you're paying out of pocket for every doctor's visit, every test, every health crisis.

If your mother handles the family's finances, insurance, etc. it isn't that far of a stretch for her to sign him up for the right plans. When I signed up for medicare, I also shopped around to find my husband an ACA plan. Your dad is putting your mother at risk of bankruptcy if he doesn't sign up for a plan. Maybe that will help sway him. Also, he has paid into it his whole working life; now he gets to reap those rewards.

Good luck!

ETA: There are "navigators" you can meet with who can step you through the plans, costs, and help you make an informed decision. They're often the same people who help people find ACA plans. Just google around and see if you can find someone good, call them, and see if you like them. They might be better at talking to your parents together and helping them find the right plans. (for ex, Michigan: https://enrollmichigan.com/find-local-help/)

[civil4life]

Not sure if this argument will help, but he paid into social security and medicare all his life.