Last year, I wrote an article about the importance of understanding Social Security early in life. Social Security is complex and it’s going to take a while to understand all of the nuances of the program. In addition, whether it’s an election year or not, Social Security is a program that is being talked about by both Democrats and Republicans. If you have an opinion about Social Security (and you should) then you will want to pay attention to what the candidates have to say and make sure your legislators know your views.
A program that is often included in the same sentence with Social Security is Medicare. It’s a national health insurance program started in 1966. Medicare primarily provides Americans over age 65 with health insurance but it does also provide benefits to some younger people with disabilities.
Medicare has four parts. Here’s a really high level overview: Part A covers hospital services. Part B covers doctors services. Part C is an alternative to Parts A & B called Medicare Advantage. And Part D covers prescription drugs. I’m sure you can already see how this is going to get complicated.
AARP recently held a webinar series called “Making Sense of Medicare” that I thought was very interesting. In fairness to them, it by no means answered everything you might want to know about Medicare. But it did provide a good foundation that you can build upon. Here are a few of my takeaways from the webinar:
- Like Social Security, Medicare is age driven. The enrollment window for Medicare begins three months before you turn age 65 to 3 months after. You can sign up online or at a Social Security office. There are consequences if you don’t sign up within your enrollment window.
- Unlike Social Security, Medicare involves making a decision. When you sign up for Social Security, that’s it…you sign up. Medicare involves making a decision: Do you want the Original plan or the Advantage plan? There are pros and cons to each. Good news though, neither plan has a pre-existing condition clause.
- The Original Plan offers more choices. Under the Original plan, you can choose any doctor. For some people, that is a very important consideration. It also means that your costs could be a bit higher. But having the freedom of choice could be worth it. Oh, and there’s no dental or vision. Individuals who choose the Original Plan often make up the difference by purchasing Medicare supplemental coverage.
- With the Advantage plan, you could have lower out of pocket costs because you’re working within the Medicare network of doctors, hospitals, etc. This could be frustrating because you have to find doctors and providers who will take your coverage. But the savings might be worth it.
- Obviously, the decision about whether to go with the Original plan or the Advantage plan is entirely yours. Everyone’s medical and financial situation is different. The good news is resources are available. AARP has a Medicare Resource Center on their website. There’s also the State Health Insurance Assistance Program (SHIP), a network on free, one-on-one counseling and assistance, designed to help people navigate the complexities of Medicare.
- Keep in mind that while Medicare could be years away for you, it’s possible you have a parent or loved one that is close to Medicare age and they might be looking for resources. The AARP Resource page and SHIP could be a way that you can help them.
- You will want to plan on reevaluating your coverages every year. The good news is that once you make a decision, it is possible to change your coverage. Granted, there might be consequences, but it could be worth it. If you’re in the corporate world, then you’re familiar with the term “open enrollment”. Well, guess what? Medicare has open enrollment too. When you sign up for Medicare, plan on participating in open enrollment for the rest of your life.
Health insurance has never been an easy subject and it doesn’t look like it will get any easier when we retire. That’s why it’s important to spend time learning about Medicare now. So, when it comes time to make health insurance decisions, we can make the best ones possible for ourselves and our families.
Image captured by Sharlyn Lauby during sunset at the Halekulani Hotel on Waikiki Beach in Honolulu, HI