Close Close
Popular Financial Topics Discover relevant content from across the suite of ALM legal publications From the Industry More content from ThinkAdvisor and select sponsors Investment Advisor Issue Gallery Read digital editions of Investment Advisor Magazine Tax Facts Get clear, current, and reliable answers to pressing tax questions
Luminaries Awards

Retirement Planning > Social Security

Seniors gain rights to refuse Medicare

Your article was successfully shared with the contacts you provided.

One of the rights being pressed in the debate over health care is an individual’s right to choose his or her health care plan. So it may seem a bit ironic that a new federal lawsuit seeks to allow seniors to keep their Social Security benefits even if they reject Medicare. Recently, a judge in Washington, D.C., granted three plaintiffs the right to do just that.

The Department of Health and Human Services had hoped to have the suit dismissed, citing “POMS” rules which state that seniors withdrawing from Medicare Part A, which covers hospital and outpatient services, must surrender their Social Security benefits. POMS was established in 1993 and set forth rules that are not in the statute or regulations governing Medicare. The plaintiffs in the case, Brian Hall, John Kraus and former U.S. House Majority Leader Richard Armey, preferred their own healthcare plans to the mandated Medicare coverage.

In Judge Rosemary Collyer’s ruling, she stated that “neither the statute nor the regulation specifies that Plaintiffs must withdraw from Social Security and repay retirement benefits in order to withdraw from Medicare.”

The DHHS argued that the plaintiffs had not exhausted the available administrative remedies for challenging POMS, but Judge Collyer noted that one plaintiff had sought an administrative hearing but had “received no response from the SSA for approximately three years.” Such refusal to respond to the plaintiff’s request amounted to exhaustion of available administrative remedies.

With Medicare facing an uncertain financial future, allowing seniors, such as these plaintiffs, to pay for their own care could save the program money. The plaintiffs argued that they should not be denied Social Security benefits after a lifetime’s worth of contributions simply because they want to pay for their own health care.


© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.