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How do I refuse Medicare?

6 answers | Last updated: Sep 30, 2015
A fellow caregiver asked...

I am alone, no children or husband. I had to take Social Security early at 62 due to no jobs available. I'll be 65 in 2010. The money I receive from Social Security in very minimal. Without getting cost of living raises for the next two years, I'll be really strapped to pay the cost of Medicare. I've gone two years without medical insurance, and therefore my medical problems have gone untreated for that time, simply because I cannot afford it. I either pay for groceries or pay for medical insurance. So, do I have to have Medicare? If so, which part do I absolutely have to have? If not, what do I need to do to NOT be automatically signed up?


Caring.com User - Joseph L.  Matthews
Caring.com Expert
Joseph L. Matthews is a Caring.com Expert, an attorney, and the author of Long-Term Care: How to Plan & Pay for It and...
38% helpful
A fellow caregiver answered...

For most people, Medicare Part A, which covers inpatient hospital bills, has no monthly premium and so there is no reason not to sign up for it. Medicare Part B See also:
V.A. Medical Benefits
, which covers doctors bills and other outpatient costs, does charge a monthly premium of $96.40 per month. You don't have to sign up for Medicare Part B if you don't want it. But it provides excellent coverage, and if you would have a hard time paying the premium, there are several programs that might be available to pay the premium for you.

Medicaid is a program of comprehensive medical coverage for people with low income and few assets other than the home they live in. If you're only income is from a small Social Security check, and if you have not more than a couple of thousand dollars in savings, you are likely to qualify for Medicaid. If you are eligible for Medicaid, Medicaid would pay the full amount of your Medicare Part B monthly premium once you reach age 65. Medicaid would also pay most of the costs Medicare Part A and Part B do not pay for Medicare-covered care (for example, the 20 percent coinsurance amount you would owe for each doctor's bill). To find out about Medicaid eligibility in your state, and to begin the enrollment process, you can contact a local Medicaid or county social services office. To find a local office, you can go to your state's Medicaid Web site by using any online search engine and entering "Medicaid" and the name of your state. Or, you can call the Eldercare Locator toll-free at 800-677-1116 and ask for contact information for a local Medicaid office near you.

Even if you have slightly too much income or assets to qualify for Medicaid, you might be eligible for another program that would pay Medicare premiums, deductibles and coinsurance amounts, or at least Medicare Part B premiums. One of these programs is called Qualified Medicare Beneficiary (QMB). If you are eligible to be a QMB, the program will pay all of your Medicare Part A and Medicare Part B premiums, deductibles, and coinsurance amounts. If you have slightly too much income or assets to qualify as a QMB, you might still qualify as a Specified Low-Income Medicare Beneficiary (SLMB) or a Qualifying Individual (QI). If you qualify as a SLMB or QI, the program will pay your monthly Medicare Part B premium, though not your Medicare deductibles or coinsurance amounts. You can apply for the QMB, SLMB or QI program when you enroll in Medicare at your local Social Security office.


More Answers
A fellow caregiver answered...

There is one reason that I know of not to be enrolled in Medicare Part A. If one's insurance package is a high deductible insurance policy and one is contributing to a health savings account. The IRS rules state that; contributions cannot be made to an HSA if one is enrolled in Medicare. To receive SSA retirement benefits for which we have paid for over the years, it seems to be a requirement that one must also be automatically enrolled in Medicare. The SSA does this.

In Washington DC, Judge Rosemary Collyer ruled that; neither the statute nor the regulation specifies that one must withdraw from Social Security and repay retirement benefits in order to withdraw from Medicare.

I have an ongoing struggle with the government buracracy. I suppose that will be happening quite a lot with us seniors. My advice is to keep the best records that you can, till the end.


A fellow caregiver answered...

Too many people provide inaccurate information on Medicare. Medicare, because of broad enrollment (not just those who are ill) has been able to keep costs lower than other insurance programs. I suggest anyone who does not want Medicare, compare the cost of private insurance without medicare. Unlike "American cars" which are now often made in China, Medicare is a truly American product. Created by working Americans, paid for by working Americans, and used by working Americans (unless for a very few, they purchase Medicare at higher rates similar to private insurance).

Mr. Mathews above does provide accurate useful information. If you are truly low-income there is help. Keeping people healthy, saves Americans money. However, in my work I do run into people who say they cannot afford the premiums, when in fact they could if they spent their money differently. It can be difficult in this day and age to realize that medical insurance may be a priority over i pods, cable, and other costs we now perceive as "necessary". Sometimes we need to make difficult choices. But if one chooses not to have insurance, they should not expect the Medical Centers/Hospitals to "forgive" their medical costs. We need honest discussions in our country, not inflammatory rhetoric. We need value government, not "no" government. I work with seniors every day and when they have the correct facts, they appreciate what our government does for them.


A fellow caregiver answered...

I am a veteran . Medicare part A seems to prevent me from getting coverage from the VA for emergency treatment, in non VA facilities. This may be a reason to refuse medicare part A.


A fellow caregiver answered...

In response to the above HSA issue, it appears that if you are the spouse of an individual whom has private insurance paid for by your spouses insurer, you can not use the HSA even if you only have Part A. This seems quite unfair and not in the spirit of Obama Care, as it causes families with one spouse whom is over 65 to pay a much higher premium for coverage than could be bought on the exchanges or through private insurance. The individual whom is paying for Part B coverage, and Part D coverage and Supplemental Insurance and is combining those costs with the portion required by an employers insurance, (for their younger spouse) is paying monthly health insurance premiums that far exceed plans available to others not in similar circumstances. The HSA rule actually amounts to age discrimination and should be changed. I am at a loss for why it would have ever been instated. Why should couples be penalized for using private health insurance that they would otherwise have been qualified to use, accept for being over age 65 or on medicare?


A fellow caregiver answered...

You cannot refuse Medicare. The penalty is you must pay back all you Social Security and you will not get SS. If you do not get SS then you can refuse Medicare. That is the only penalty