5 Facts you need to know when turning 65 & qualifying for Medicare

1. If you are not retiring and have creditable insurance coverage through your company:  you do not have to pick up Medicare Part B.

Please consult with your Human Resources department about creditability.  Also, V.A. recipients are not required to enroll in Part B. If veterans do not enroll in Part B, then they will be completely dependent upon the V.A. for the administration of healthcare.  I sat down recently with a new client, who is over 65 and still working.  Through Medicare consultation, I learned that she has been unnecessarily carrying Part B for 22 years.  This was her first Medicare consultation.

2. Understand the difference between Medicare Advantage Plans & Supplemental Plans.

Medicare Advantage Plans are an alternative to traditional Medicare that work like traditional medical insurance where there are networks of doctors, copays, deductibles and maximum out-of- pocket costs when in the hospital. Medicare supplements fill in the gaps for healthcare costs that Medicare does not cover. In 2008, the government put forth a less expensive alternative to the traditional Medicare supplement.  Many people opted out of their supplemental plans and enrolled into Medicare Advantage Plans because the premiums are less expensive. The most common issue with Medicare Advantage Plans are the out-of-pocket costs when admitted to the hospital. On average, Medicare Advantage recipients will incur $2000.00 in expenses, if they are admitted to a hospital. Check your plans maximum out-of-pocket costs. I’ve seen bills run as high as $6000.00 dollars.

3. Choose a part D plan based on your current intake of prescription drugs.

Your independent agent should walk you through this process. If you don’t take prescriptions, the government still requires that you enroll in a plan.  If you do not enroll when you turn 65, then the government will assess a 1% penalty for the average annual cost of a Part d plan.  Only those who have credible coverage through employment or the V.A. are excused from this penalty.  This penalty will be assessed for every month you are not enrolled and will last a lifetime. Most people who do not consult with a independent agent are completely unaware of this penalty.

4. Medicare only guarantees 20 days in a rehabilitative facility.

Have a plan for long term care.  In the past, Medicare would cover up to a 100 days of skilled and custodial care. For example, a retired teacher had 3 strokes that paralyzed the left hand side of her body. She was discharged from the rehabilitative facility after 30 days and sent to her daughter’s home where she had to hire in-home care.  She was under the impression that Medicare and her supplement would cover the cost of custodial care in the home.  Custodial care consists of bathing, dressing, eating, transferring and caring for incontinence (ADLs the activities of daily living).  Medicare does not cover these costs.

5. Get an educational consultation

There are many Medicare options available.  Have an independent agent sit down with you for an educational meeting.  This is not your mom and dad’s Medicare.  The majority of people I have consulted over the years don’t understand that Medicare is not a one size fits all program. If their health permits, they can shop the market for better priced Medicare supplements.  The premiums vary from company to company.  However, the plans offered do not change. Medicare Advantage works the same way.