The quagmire that is Medicare

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I am a senior citizen and I am well aware of the health care minefield ahead for some baby boomers. I have a few suggestions on how to navigate thru this to share. Start your healthcare planning well before you plan on retiring so you don’t have a lapse in medical coverage.

I have found that when it comes to a Medicare plan, there are so many options that it might be hard to select the best plan for yourself.  You may be the type of person who goes to the doctor once a year or you might have a history of health issues. You might talk with your doctor and see which type of plan they recommend. They are possibly the best judge of your insurance needs.

I called the big three insurance plans in the Buffalo area for guidance. One of them said I could come down to their offices and discuss my options with them. That wasn’t going to happen. If you want my business you should come to me not make me waste two hours of my time driving to give you my money. The second company sent me a tome that made “War and Peace” seem small and told me to figure it out myself. The third carrier sent out a representative to explain all my options and help me select the best plan based on my medical history. Guess which company got my business.

Original Medicare with a Medicare Supplement or a Medicare Advantage plan may fit your needs. The state of New York offers a drug plan for seniors called The Elderly Pharmaceutical Insurance Coverage (EPIC) program. This is administered by the NYS Department of Health. This is generally less expensive than any commercial offering.

I was concerned about what will happen if I made the wrong choice by enrolling in a Medicare Advantage plan and needed to return to Original Medicare with a Medicare Supplement. There are protections in place for this type of situation. A Medicare rule from the Medicare & You Handbook says: “If you join a Medicare Advantage Plan for the first time, and you aren’t happy with the plan, you’ll have special rights to buy a Medigap policy if you return to Original Medicare within 12 months of joining.”

There are many ways that a Medicare recipient can change their Medicare plans during Medicare’s Annual/Open Enrollment. You can purchase a Part D Medicare Prescription Drug Plan or change from one plan to another. You can change from the Medicare Advantage Plan that you have to a different Medicare Advantage Plan. You could even return to Original Medicare.

It might surprise some people to know that Medicare is not free, that if you want to get a Medicare supplement policy (Medigap), there is also a premium that you need to pay over and above the Medicare part B premium and other premiums that you are paying. Medigap is priced differently based on different situations. This might also add to your confusion. Premiums that you will pay should be clear as you decide which Medicare options you will get. To help you with understanding the costs you can head on to freemedsuppquotes.com/learn-the-basics/cost-Medicare-supplement.

I get social security, however I have to pay for Medicare right off the top of my monthly distribution. Then I have a supplemental insurance that I pay for monthly. The state of New York has a senior citizen drug program called Elderly Pharmaceutical Insurance Coverage or EPIC that I also pay for, to help with my prescriptions.  You would think that after paying for all this I would have absolutely no bills for medical treatment but nooooooo.

I have worked hard my entire life, have paid my taxes faithfully, including social security since I started working at 18. I also saved as much money as possible investing in IRAs, 401Ks and pensions anticipating a comfortable retirement. I took my social security at age 66 so I could get my full social security “Benefit” (there’s an oxymoron, I paid into this fund how is this now called a “benefit” it’s not like they are giving me something, they are just giving my money back to me).

Having insufficient income is a problem that faces many seniors. A 2016 survey by the Transamerica Center for Retirement Studies finds that baby boomers—those born between 1946 and 1964—have median retirement savings of $147,000. This falls short of the amount they will need.

Seniors worry about paying for healthcare and having enough left over for food, taxes, etc. People like myself are faced with the problem of paying for necessary medical appointments, co-pays, drugs and basic living expenses. Do we leave the air conditioning off to save money? Do we leave the furnace turned down to save on our gas bill? Do we buy our drugs instead of food? These are questions that no one should have to be concerned with.

We provide free health care to people on public assistance but not to senior citizens. Applying for Medicare also has to be made easier. If you can enroll in less than 2 trips you are lucky. A high quality, cradle to grave health care system for everyone would take away one of America’s biggest headaches. The American system is broken and needs to be fixed.

Norb is a senior citizen living in Lockport. He can be reached at nrug@juno.com.

    Tagged with: senior citizen, health care, Medicare, Epic

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