Married vs Domestic Partner with Employer Benefits and Delayed Medicare Part B


By Tony King


My problem is different from that of most couples I’ve read about in your weekly Medicare column. I find out that my company’s group health plan does not pay any Medicare Part B medical expenses since my husband is actually a domestic partner. We’ve been together for over 25 years, but never officially married. Richard is 72 and I am a 58 year old female who now needs to learn the Medicare maze

Richard has serious health issues with 2 stents in his heart and recent back surgery, which is now costing us thousands of dollars because my company’s group health plan is not paying for his doctor’s care. Richard never enrolled in Medicare Part B because I was always the “working spouse”. Now I find out that the group health plan (the company’s self-directed group health plan) doesn’t recognize “domestic partners” as a married couple because we don’t have a marriage license

Now he has to sign up for Medicare Part B, and since he’s 72, if he doesn’t do it right, the sentence will be over 7 years. From what I read in your articles, it could be a 70 or 80% penalty forever. In the end, we need HELP!! Thanks, Gabby, Phoenix, AZ


Enrolling in Medicare Part B must be a rush job! You are in the middle of the Medicare maze and Richard needs Medicare Part B immediately!

This is a new Medicare question for the Toni Says® Medicare office. America needs to know the Medicare rules about deferring Medicare Part B, when there is an unmarried domestic partner situation (same or opposite sex), and they receive health insurance through of their partner’s employer.

Always discuss delaying your domestic partner’s health insurance Part B with your company’s health insurance benefits administrator or human resources department to find out what’s in the company’s handbook. insurance regarding health insurance rules for unmarried domestic spouse.

Group size may not make a difference. Whether there are less or more than 100 employees on your unmarried spouse’s group health insurance plan, it is worth checking with HR or the insurance plan if you generally should not delay Part B of Non-working domestic partner’s Medicare. As I said earlier in this article, always check with your benefits or human resources department about the consequences that may arise when your domestic partner delays their Medicare Part B and if there might be a possibility of receiving a late Part B penalty, when they must enroll in Medicare Part B at a later date.

I wrote about the “Special Enrollment Period” and the Social Security form titled CMS L-564 “Employment Information Request” completed by your HR or office manager. Richard could have his Medicare Part B with an effective date of the first of next month.

Richard will need to bring 2 Social Security forms, the CMS L-564 “Request for Employment Information” signed by the employer’s HR department as well as the CMS 40-B “Request for Health Insurance Part B” at his local social security office.

During a Toni Says Medicare consultation, we advise clients to meet with a Social Security representative in person (if possible due to COVID-19 social distancing) or fax them directly to the specific office or leave them in the social security office mailbox. Remember to always make copies of every document given to the Social Security office or received from the Social Security office.

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