Q: My wife signed up for Medicare when she was 65. But she didn’t apply for Social Security benefits until she was 66 years old this past March. At that time, she filed a restricted claim, taking spousal benefits on my record. She plans to save her own retirement benefits until 70. She’s had some medical problems recently and so she has had to use her Medicare. But we’ve learned it is all messed up. After the doctor’s office submitted her claims, we got letters from Medicare denying those claims because they said they have no record of her in their files. She had no problems last year when she had some prior Medicare claims. Can you guess what is going on?
A: I think I know exactly what is going on. But before I explain your Medicare mess, I want to clarify your Social Security situation to those readers who may be confused by what your wife has done.
She has employed the popular Social Security maximizing strategy known as “file and restrict.” The law says that if she waits until age 66 to file for Social Security, she can forgo her own benefits and instead file for spousal benefits on your record. She will receive those benefits (at a rate equal to 50 percent of your full retirement age benefit) until age 70, at which point she will file a retirement claim on her own account and get a 32 percent bonus added to her monthly retirement checks.
Some people may have heard that this maximizing provision was outlawed earlier this year. But what got the kibosh in April was another strategy called “file and suspend.” People can still pull off the “file and restrict” gambit as long as they turn 66 before January 2020.
One of the downsides to employing the file and restrict Social Security strategy is that your wife’s Medicare is going to be messed up for a while. And it all has to do with your wife’s Social Security “claim number.”
Medicare isn’t managed by the Social Security Administration. Instead, it is run by another federal agency called the Centers for Medicare and Medicaid Services. CMS doesn’t have field offices around the country, so they rely on SSA to get people enrolled in the Medicare program. Because of this link between the two federal agencies and two government programs, government officials decided a long time ago to use the Social Security claim number as the Medicare number. In the “old days” that was fine. Most folks simply claimed either their own Social Security benefits or they claimed benefits as a spouse. There rarely was any switching back and forth from one kind of Social Security benefit to another.
But with advent of the aforementioned maximizing games, people are switching back and forth between one benefit and another all the time.
For example, when your wife filed for Medicare at age 65, she did so under her own Social Security number. So at the time, she got a Medicare card with her own Social Security number on it. It probably had the letter “T” behind it. (“T” is the symbol SSA uses to denote someone who has filed for Medicare but has not yet filed for Social Security benefits.)
But in March of this year, you said your wife employed the file and restrict strategy, claiming spousal benefits on your record. So her Social Security claim number is now your Social Security number with a letter “B” behind it. (“B” is the symbol SSA uses to denote wife’s benefits.)
My hunch is that when her doctor’s office submitted the claims to Medicare, they used her original Medicare number (her Social Security number with a “T” behind it). Tell them to resubmit the claims with her new Medicare number (your Social Security number with a “B” behind it).
Once all this gets straightened out, things should go swimmingly for a while. But when your wife turns 70 and files for her own retirement benefits, she will get yet another Medicare card. It will be her own Social Security number with an “A” behind it. (“A” is the symbol SSA uses to denote retirement benefits.)
In other words, in the space of five years, your wife is going to have three different Social Security claim numbers and Medicare numbers. And I’m afraid you are just going to have to be prepared to deal with some Medicare claim filing headaches because of this.
I wonder if it would be better if CMS could simply issue their own claim number to be used on Medicare cards? On the one hand, it would help avoid the kinds of problems mentioned in this column. On the other hand, it would give people yet another government identification number they would have to use.
And here is one final Medicare note to end this column. I get Medicare questions emailed to me all the time. I have mentioned many times before in this column that I am not much of a Medicare expert. As a retired SSA official, I know all about the Social Security program. But I am not much help to people who have Medicare problems, except for relatively minor enrollment issues as discussed above.
If you have Medicare questions, I can steer you in the right direction. CMS has a website: www.medicare.gov. You should be able to find lots of help there.
Although CMS does not have a network of field offices, it does have a cadre of volunteers who can help you out with almost any Medicare problem you have. These volunteers are called State Health Insurance Program counselors or, in some states, the Health Insurance Counseling and Advocacy Program. To find the counselor nearest you, go to www.medicare.gov . On the homepage, look for the link labeled “Find someone to talk to,” pull down the menu for your state and click on “SHIP” or “HICAP.”
