In 2012, when we began our travels, we decided we wouldn’t sign up for Part B Medicare when we turned 65. In 2013, I turned 65 (I am 5 years older than Tom). Qualified Individuals over 65 years old receive Medicare Part A as follows:

“*Generally, you’re eligible for Part A if you are 65 or older, meet the citizenship and residency requirements, and get disability benefits from Social Security or the Railroad Retirement Board for at least 25 months.”

What does Part A cover?

“Part A (Hospital Insurance): Helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care. Part B (Medical Insurance): Part A covers Inpatient surgeries, lab tests, and drugs related to the inpatient stay. Medicare Part A doesn’t cover doctors’ services even for Medicare-approved stays. There’s no cost for Part A for qualified individuals.

What does Part B cover, and what is the monthly premium deducted from Social Security, or in our case, Railroad Retirement?

Part B Medicare or other medical insurance may provide coverage for Medicare. Part B helps cover medically necessary services like doctors’ services and tests, outpatient care, home health services, durable medical equipment, and other medical services. Part B also covers some preventive services. Look at your Medicare card to find out if you have Part B. The government charges a monthly fee for Part B, which is now:

$174.70 in 2024 or higher, depending on your income. The amount can change each year. You’ll pay a monthly premium, even if you don’t get any Part B-covered services. “Higher income” is construed as follows:

If you file your taxes as “married, filing jointly,  and your MAGI, adjusted gross income exceeds $206,000, you’ll pay higher premiums for your Part B and Medicare prescription drug coverage. If you file your taxes using a different status and your MAG exceeds $103,000, you’ll pay higher premiums.

When we didn’t sign up for Part B Medicare since we were traveling outside the US and accepted the future penalty, and had no use for it, when Medicare doesn’t pay for care outside the US, the following penalty was assessed per year when I finally decided to send in my enrollment for Part B as follows on January 2, 2024:

“Medicare Part B has a 10% penalty on your monthly premium for each 12-month period you delay enrollment. This penalty is lifelong. In 2024, the penalty is based on a monthly premium of $174.70.”

As a result, after ten years without enrolling in Part B, my cost for Part B will be $349.40 monthly. Had I known in 2013, when I chose not` to sign up for Part B, that I’d have heart problems, I would have enrolled when I turned 65. It wasn’t until 2019 that my heart issues were discovered. At that point, we would be out of the US for years to come, and we decided to continue to wait until we returned to the US for extended periods.

Now that we’re spending more time in the US and with the discovery of future potential heart surgery, it was time for me to sign up. If I eventually need additional surgery after having tests in the US while we’re here, I will be covered.

Since Medicare Part A and Part B don’t cover everything, resulting in huge co-pays that can be life-changing and stressful, a “supplement” is necessary to cover the costs of potential co-pays, which could run into tens of thousands of dollars if not covered by Part A and Part B.

I looked online but became frustrated when I understood how supplements work. Every site I searched required me to fill out a form with my personal information to receive a call back to review the possibilities of a supplement. I started getting dozens of phone calls each day, and I didn’t want to return all those calls. However, in the process, I answered many of the calls and became more frustrated in the process.

I had run out of patience with agents whose primary goal was to sell me a plan that earned them the most commissions (the government pays).

During this period, I stumbled across a no-pressure, knowledgeable Medicare insurance agent, Janet Mueller, who gently walked me through the process, answering my seemingly endless stream of questions. I couldn’t have been more thrilled with her service and attention to detail. I’d highly recommend her services if you need help with a supplement and/or pharmacy plan. She can be reached at jmueller@teameip.com. Janet’s concern was only for those plans that would serve my needs with the best possible price and terms.

This post is getting long, so we will continue tomorrow with the plan Janet helped me decide is suitable for my circumstances. We’ll be back tomorrow with Part 2 regarding the supplement I chose and decisions regarding a prescription plan. See you then!

Be well.

Photo from ten years ago today, January 12, 2014: