Dear Rusty: I’m nearing 68 years old, have never signed up for Medicare, but am thinking that I should look into it. I’m currently covered by my wife’s health insurance through her employer. I would greatly appreciate some simple guidance regarding Medicare. I’ve tried watching some videos about the subject, but it was always so boring that I never finished watching. I get lost in all the “Part This” & “Part That.” I would just like some solid insight into the coverage that I truly need and the cost.

Signed: Confused

Dear Confused: Medicare is, indeed, a confusing topic, but I’ll try to clear it all up for you. Think of it this way, Medicare has two main parts — one that provides coverage for in-patient hospitalization services (that’s called Part A) and another which covers outpatient services like doctors, medical tests, and more (that’s called Part B). Part A is usually free (if you’re getting or will get Social Security), but there is a monthly premium for Part B. For 2023, the monthly Part B premium will be $164.90, and that’s either deducted from your Social Security payment, or paid directly to Medicare if you’re not yet collecting Social Security. 

There are deductibles and copays for both Part A and Part B, so they don’t cover 100 percent of your health-care expenses — they generally cover about 80 percent of specific types of medical services, after deductibles are satisfied. The deductibles aren’t high — $226 for Part B and $1,600 for Part A — but that still leaves you with some uncovered health-care costs under Medicare. And for those uncovered costs, many people choose to get additional private coverage, known as a “Medigap” (or Medicare Supplement) plan, or a Medicare Advantage plan (which is usually called Medicare “Part C”). This additional coverage isn’t mandatory, but usually prudent to have. 

The standard age for enrolling in Medicare is age 65, but if you have other “creditable” health-care coverage from your wife’s employer you can defer enrolling in Medicare until that employer coverage ends or is about to finish. Having that “creditable” employer coverage after age 65 protects you from incurring a late-enrollment penalty for enrolling in Medicare after age 65. From what you’ve written (assuming your employer coverage is “creditable”) you can enroll in Medicare at any time now without a penalty for enrolling after 65. You can enroll online at www.ssa.gov/medicare, or by calling the Social Security Administration at (800) 772-1213. 

Medicare Part A and Part B do not include coverage for prescription drugs. For that, you would need to acquire a private prescription-drug plan (called Medicare Part D), if you wish such coverage after age 65 and after your employer drug coverage ends. Part D plans aren’t usually expensive — in the $15-$50 per month range — depending on the specific plan and drug “formulary” (the amounts the plan pays for each type of drug). To sort all of this out and figure out your best options for additional coverage, you may wish to contact AMAC’s Medicare department (www.amac.us/medicare) and speak with a Medicare insurance specialist. 

To recap, in your personal circumstances you are eligible to enroll in Medicare without penalty, even though you’re now 68, because you have had “creditable” health-care coverage through your wife’s employer since you were 65 (“creditable’’ is a group plan with at least 20 participants). You can also simply stay on that employer plan if you wish, and only enroll in Medicare when your employer coverage ends or is about to end. At that time, you will enter a Medicare special enrollment period, during which you can enroll in Medicare without incurring a late-enrollment penalty. The bottom line? If your current coverage from your wife’s employer is creditable and suits your current needs, you can wait until that coverage ends to enroll in Medicare. The only caveat is that you must take free Medicare Part A if you collect Social Security after age 65.          

Russell Gloor is a national Social Security advisor at the AMAC Foundation, the nonprofit arm of the Association of Mature American Citizens (AMAC). The 2.4-million-member AMAC says it is a senior advocacy organization. Send your questions to: ssadvisor@amacfoundation.org.

Author’s note: This article is intended for information purposes only and does not represent legal or financial guidance. It presents the opinions and interpretations of the AMAC Foundation’s staff, trained and accredited by the National Social Security Association (NSSA). The NSSA and the AMAC Foundation and its staff are not affiliated with or endorsed by the Social Security Administration or any other governmental entity.

On Dec. 14, 2022, the National Labor Relations Board (NLRB or Board) issued a decision that (again) modifies its standard for bargaining-unit determination cases where a labor union seeks to represent a unit that contains some, but not all, of the job classifications at a particular workplace. The decision, in American Steel Construction, Inc., revives the Board’s prior test governing such determinations set forth in the Specialty Healthcare & Rehabilitation Center of Mobile decision of 2011, which was overruled in the PCC Structurals ruling of 2017, and The Boeing Co. decision in 2019.

In its 2011 Specialty Healthcare ruling, the Board identified the elements to be satisfied if the proposed union was to be recognized. Among these were that the unit is “sufficiently distinct.” If a party contested the petitioned-for unit on this ground — thereby arguing that certain employees not included in the proposed unit should have been — it would bear the burden of proving that there was an “overwhelming community of interest” between the petitioned-for employees and excluded employees in order to add the excluded employees to the petitioned-for unit. This was a difficult standard for employers to meet and widely recognized as a boon for union organizing. In the wake of the Specialty Healthcare decision, unusual “microunits” were organized, including cosmetic and fragrance-counter employees at a Macy’s department store. 

In its 2017 PCC Structurals ruling, the NLRB overruled the Specialty Healthcare decision and adopted a different test for the “sufficiently distinct” element. Instead of the “overwhelming community of interest” test, the Board adopted a test whereby “the interests of those within the proposed unit and the shared and distinct interests of those excluded from that unit must be comparatively analyzed and weighed.” This test therefore removed the burden from the employer challenging the composition of the bargaining unit and instituted a balancing test that did not explicitly begin with deference to the petitioned-for unit. The test gave employers far greater ability to oppose recognition of a bargaining unit consisting of some, but not all, of the employees within their workplace. 

[The recent] decision in American Steel expressly overrules PCC Structurals and Boeing and reinstates the “overwhelming community of interest” standard of the Specialty Healthcare decision. The NLRB elaborated that this means that when there are only “minimal differences, from the perspective of collective bargaining… then an overwhelming community of interest exists, and that classification must be included in the unit.” The Board indicated that meeting this standard would be akin to showing that “there is no rational basis for the exclusion.” So long as the petitioned-for unit consists of a clearly identifiable group of employees with a shared “community of interest,” the NLRB will presume the unit to be appropriate. The impact of this decision is to again empower unions and employees to organize along narrower lines of job classification. Even prior to the American Steel decision, employers have seen a significant uptick in organizing activity in the last several years. This decision will likely further invigorate unions to again focus on “micro units” as a path to organizing workplaces, and employers again face the prospects of multiple distinct bargaining units among their employees.      

Peter H. Wiltenburg is an associate attorney in the Buffalo office of Syracuse–based Bond, Schoeneck & King PLLC. He is a litigation attorney in the firm’s labor and employment practice with extensive experience representing corporations, municipalities, and individuals in all phases of litigation, from case inception through trial and appeal. Contact him at pwiltenburg@bsk.com. This viewpoint is drawn and edited from the firm’s New York Labor and Employment Law Report blog.