Just discovered parents do not have Medicare Part A coverage.

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Just discovered parents do not have Medicare Part A coverage.

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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.

Hospice Medicare Part A Parents Paying for Care

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HappyRobins suggestion on contacting SHIP is really good. You might also contact Center for Medicare advocacy 202/293-5760.

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.

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7/26/23
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.

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This Medicare.gov page https://www.medicare.gov/talk-to-someone provides a variety of ways to talk to someone either at Medicare or in your state.

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.

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Update: Finally uncovered the fact that neither had paid into SS taxes for Medicare which wasn't required while they were working. Therefore, neither are eligible for Part A. However, I'm currently trying to get together with SS office (right?!) and should be able to sign my mother up for a premium of $506/mon - which would be worth it at this point to be able to get her into Hospice. Everyone that plans to grow old needs to check to make sure they have Medicare Part A...just saying...

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My dad is in the same situation with his Blue Cross/Blue Shield providing the hospitalization coverage and Medicare Part B for his doctor visits. He was covered under a system that no longer exists for insurance coverage in many government jobs which your parents may have had as teachers. The hospitals never can figure it out and usually cite some spurious HIPPA restriction (that doesn't exist) to prevent me from explaining it to them. Usually they keep sending me bills, which I keep telling them to send to BC/BS until they give up. Luckily my dad is also retired military so has TRICARE in additional but that usually just adds to the confusion. When my mother needed hospice we had to cancel her BC/BS so that the Tricare would become primary so that it would cover hospice. The hospital social worker helped us figure it all out. Have you been able to contact a patient advocate or the hospital social worker to help you on this? We'd never have been able to get it all done on our own as no one could ever understand our problem.

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I appreciate your feedback and suggestion to work with the hospital social worker. The AL facility's SW is looking into trying to find a Hospice that will take my mother without Part A or possibly probono? I've called advocates for Seniors regarding Medicare who had me call Medicare directly who have me calling Social Security...still haven't been able to talk to a representative but will continue to hold...and try contacting whoever until hopefully, I find someone who can help.

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"You can sign up for Part A any time after you turn 65. Your Part A coverage starts 6 months back from when you sign up or when you apply for benefits from Social Security (or the Railroad Retirement Board). "

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.

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Igloos info was interesting. I know my cousin gets less SS in Cal because he has a teachers pension. Having enough quarters is interesting too. My cousin got his quarters in long before he taught school.

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.

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We always thought it was a given that they had A&B. I worked at the same school, paid the same SS and retired with the same TRS insurance. I and my husband have both A&B. Because of their TRS Advantage (which I thought was the Medicare A) their hospital bills have always been covered. It wasn't until now that we're trying to obtain Hospice that we discovered neither has Part A. All agencies seem as dumbfounded as we are.

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One of the things we need to do as parents, is make sure our paperwork is in order and our children understand what we have and don't have. I have a small filing cabinet. I am about to go thru it again and make some changes to make it as easy as I can for the girls.

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If this experience has done nothing else, it's made us aware as parents what we need to do to make life easier for our children should we need to depend on them for care. Definitely get everything you can in order and make sure it's accessible to them. Blessings.

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It's a pity what seems to have happened to Hospice in some instances. Where I live, a very large hospital that is part of a huge very profitable national network, in the last year entirely shut down their Hospice unit.

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UPDATE: After months of trying to work with the SS office, submitting form after form, phone calls & letters (all to no avail), our Hospice that took care of my father hired a new accountant and guess what?! Apparently, Medicare Advantage (which they do have) DOES cover Hospice care so we don't need the Medicare Part A to pay when my mother does qualify for Hospice.
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.

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original Igoo here, wow! MamaChar, so SO happy for you! And your postings and updates on all this will help others.
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.

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Medicare Advantages are contracted out by Medicare and must cover everything that Medicare A & B cover. They also cover prescriptions, vision, and dental that people with straight Medicare have to pay for out of pocket because Medicare A&B do not cover these things.

Glad everything got straightened out.

Just discovered parents do not have Medicare Part A coverage.

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