Can you get back Medicare Part A coverage if it has been dropped?

Dianna in md asked...

My 84-year-old mother-in-law has Medicare Part B but not Part A. We are totally confused. She has been in the hospital approximately 8 times. Fortunately, the hospitals where she stayed billed as an "outpatient" under Medicare Part B.

Both my mother and father-in-law worked for the federal government. Father-in-law passed away in 1989. My mother-in-law thinks Part A was eliminated when about 50 years ago the government suggested they combine their individual policies into a family one. And, BC/BS would pay for everything.

My mother-in-law is the only patient in the local hospital that does not have Medicare Part A. We live near a large military base where many others in our region worked for the federal government during and after WWII.

How could this happen? She needs skilled nursing services but we are told that her BC/BS only covers one life-time stay, which she has used. Without the Medicare Part A, she can not be admitted to a facility unless it is private pay.

We don't know what to do or how this happened. Any ideas or suggestions?

Expert Answer

Your mother-in-law certainly can enroll in Medicare Part A, but the real question is whether she is entitled to Part A coverage without paying a high monthly premium. People age 65 or older who are eligible for either Social Security OR civil service -- including federal government employment -- retirement, dependents, or survivors benefits are eligible for Medicare Part A without having to pay any premium. In other words, your mother-in-law should get free Medicare Part A coverage if either she or your father-in-law was entitled to retirement benefits (and the other one, therefore, entitled to dependents or survivors benefits) from Social Security or the federal civil service retirement system.

If neither your father-in-law nor your mother-in-law was entitled to Social Security or civil service retirement, dependents, or survivors benefits based on either one's work (one of them would need 40 quarters, or ten years, of covered work), your mother-in-law could buy Part A coverage by paying a monthly premium. For people with 30 to 39 quarters of Social Security or civil service work credits, Part A coverage costs $248 a month; for those who have fewer than 30 quarters of work credits, Part A costs $450 a month. However, there may also be a penalty added on top of these amounts for your mother-in-law if she has been eligible for Part A but did not enroll when she could have.

You should immediately contact your local Social Security office to find out what your mother-in-law's status is both under the Social Security system and the federal civil service retirement system. Once they determine her status, she can enroll in Medicare Part A at the Social Security office.