Social Security and Medicare Part B confusion - do we need it with employer coverage?
Just found out my husband (turning 67 next week) was automatically enrolled in Medicare Part B when he filed for Social Security retirement. Now they're deducting $238/month for Part B even though we have good health insurance through my employer where I'll be working for at least 3 more years! I thought we could delay Part B enrollment without penalties as long as we had employer coverage? The Social Security office made it sound mandatory when he applied. That $238 monthly deduction is making a huge difference in our budget - we're trying to help our daughter with college expenses and every dollar counts. Has anyone successfully declined Part B while keeping their SS retirement benefits? How do we fix this and get that money back? I've called the 800 number three times and can't get through to anyone who can help.
16 comments
Amina Diallo
Your husband doesn't need Part B while covered under your employer plan! He can definitely decline it if your employer has 20+ employees. You'll need to complete Form CMS-L564 "Request for Employment Information" that your employer needs to sign, proving he has current coverage. Then submit that with Form CMS-1763 "Request for Termination of Premium Hospital and/or Supplementary Medical Insurance". He can disenroll and won't face penalties later as long as he enrolls within 8 months after your employer coverage ends.
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CosmicCowboy
•Thank you SO MUCH for this info! I had no idea about these specific forms. Do we submit them to Medicare or Social Security? And will they refund the premiums already taken out?
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Oliver Schulz
I went through this exact situation last year with my wife. The SSA automatically enrolls everyone in Part B when they start collecting retirement benefits, but you can definitely opt out if you have qualifying employer coverage. It's crucial that your employer has 20+ employees though - if it's a smaller company, different rules apply and you might actually need to keep Part B to avoid future penalties.
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CosmicCowboy
•My employer definitely has over 20 employees (it's a large hospital system). This makes me feel better knowing others have successfully navigated this. Did you get refunded for premiums already paid?
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Natasha Orlova
you need to go to ssocial securityy office in person with proof of your work insuranse. they did same thing to my husband and took $$ for 3 months before we fixed it!! make appointment now don't wait
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Javier Cruz
•But getting an appointment these days is almost impossible! I tried to schedule one for my Medicare issue and they said it would be 6 weeks out. Ridiculous!
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Emma Wilson
When I tried to opt out of Part B while collecting Social Security, I had to jump through SO MANY HOOPS. The system is deliberately confusing because they WANT everyone enrolled in Part B regardless of whether you need it or not. I had coverage through my wife's job but still had to provide mountains of paperwork proving it was "creditable coverage" - and even then they still took out premiums for TWO MONTHS before processing my disenrollment. Then waited another 6 weeks for refunds! The whole system is broken!!
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Oliver Schulz
•While there are definitely frustrations with the process, I wouldn't say the system is deliberately confusing. The automatic enrollment is designed to protect people from missing deadlines and facing permanent penalties. But I agree they could make the opt-out process more streamlined for those with employer coverage.
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Malik Thomas
I was in literally this same situation! SSA and Medicare are actually separate agencies even though they seem connected which makes everything twice as complicated. Your husband needs to contact Medicare directly about canceling Part B, not Social Security. My husband wasted weeks talking to the wrong people before figuring this out!
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NeonNebula
After trying for weeks to reach someone at Social Security about my Medicare Part B issue (similar to yours), I discovered a service called Claimyr that got me connected to an actual SSA agent in under 20 minutes! Saved me hours of hold time and frustration. Their system works with the SSA phone system to get you through the queues. I watched their video demo (https://youtu.be/Z-BRbJw3puU) and was skeptical but it actually worked. I was able to get my Part B situation completely resolved in one call after weeks of trying on my own. Just sharing since you mentioned not being able to get through on the 800 number.
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CosmicCowboy
•This sounds promising! I've literally spent hours on hold this week. I'll check out that video - at this point I'm willing to try anything to get this resolved quickly.
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Javier Cruz
My friend had the same problem when he signed up for SS benefits. He had coverage through his wife but they signed him up for Part B anyway. Don't you just love government efficiency? 🙄
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Natasha Orlova
be careful cancling part B!! my sister did that and when she tried to get it back later they made her wait till special enrollment period and charged her more money forever!! make sure u really don't need it
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Amina Diallo
•This is actually an important point, but there's a key distinction. What happened to your sister was likely because she didn't have qualifying employer coverage when she canceled Part B. When you have qualifying employer coverage (from an employer with 20+ employees), you qualify for a Special Enrollment Period when that coverage ends, avoiding the late enrollment penalty. It's only people who cancel Part B without having other qualifying coverage who face penalties later.
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CosmicCowboy
Update: I finally got through to someone at Medicare this morning! They confirmed what many of you said - my husband CAN disenroll from Part B without penalty since I have employer coverage. We need to submit those two forms mentioned earlier and should get a refund for premiums already paid. They said processing could take 6-8 weeks but at least we're on the right track now. Thank you all for your help!
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Oliver Schulz
•Great news! Make sure to keep copies of EVERYTHING you submit and get a confirmation number or receipt if possible. It doesn't hurt to follow up if you don't see the refund after 8 weeks. Glad you're getting it sorted out!
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