Hitting the Medicare Milestone

Just some of my fan mail.

The flood of mail started around September and hasn’t let up yet. I will turn 65 – the magical age for Medicare – in January and I’ve received at least two… or three… or more letters, brochures, and flyers a day begging me to sign up for this Medicare plan or the other.

Those of you who live in a country that considers healthcare a right for every citizen no matter what age, feel free to shake your head in pity and not read the rest of this post.

As I was perusing the various plans—and the options within each—I thought about how my upcoming birthday changes my appeal to the insurance companies. At 64, healthcare coverage on the open market is somewhat limited and very expensive. Even in good health, someone that age is viewed as a potential drain on their bottom line. But, as soon as my odometer clicks over to 65, I’m desirable again.

As far as I know, I will continue to get older and, as far as I know, the natural aging process can will eventually bring health challenges. Yet, they all want me to sign up for their plan.

I’m pretty sure the insurance companies aren’t offering me reasonably priced healthcare coverage out of the kindness of their hearts. Whatever agreement they’ve worked out with the government must benefit them financially.

Don’t get me wrong, I am grateful for Medicare and the comfort having good coverage brings. I just have a sneaky suspicion that it isn’t as cost-effective as it could be. Insurance companies rarely lose when negotiating with our government.

Anyway, after looking through all the options—and wondering why the heck this needs to be so complicated—we’ve made the decision that we think is best for us now. Next year, and every year going forward, we will have to reevaluate, based on our current circumstances. As we get older, I imagine this annual reevaluation will become more difficult. Call me crazy but it seems that having one plan that covers everyone would be easier to manage and less expensive.

If you, or a loved one, will turn 65 in 2021, I encourage you to start doing your homework now. There are many decisions to make and missing certain deadlines can be costly. You might feel overwhelmed and/or confused enough to want to just ignore it all together. Don’t.

Attend a few seminars if you can. Talk to your friends, family members, and colleagues. Ask how they made their decision and if they’ve found any helpful resources. One company you might want to check out is Boomer Benefits. They have a great website that contains a lot of information, answers to common questions, videos, and webinars. In addition, most areas have local Medicare insurance advisers who might be able to help you sort through the various options (at no cost to you).

Good luck and stay as healthy as you can. The best healthcare plan is the one you don’t have to use.

Author: Janis @ RetirementallyChallenged.com

My blog is about travel, relationships, photography, and whatever else pops into my head (even, sometimes, issues surrounding retirement and aging).

93 thoughts on “Hitting the Medicare Milestone”

  1. I don’t envy you this process, but I think we all agree that healthcare coverage in our aging years is critical … especially in the shadow of a pandemic.

    I too turn 65 in the new year, although you beat me to it. I have to wait until March and I’m more than happy to wait.

  2. You’ve done your homework. Good for you! It’s good that you warned others to check things out. My husband was slightly late signing up, and he will pay a small penalty the rest of his life.

  3. Oh my goodness, I don’t envy you that project since we just completed it in October. That website is interesting. We have our insurance through my husband’s former employer so we deal with their choices through a broker. It’s tedious, somewhat stressful, and takes quite a bit of time. Then again, we had some scheduling issues this year. For about four years we were lucky and the program we had worked for us so we just kept it. Then they dropped some options this year, and we had to shop again. If it hadn’t been a pandemic, I would have gone out and celebrated the day we finished the process. 🙂

    1. We are staying with my husband’s retirement program also. So far, it gives us fairly robust coverage but at a bit higher cost. I was so happy when I could throw all of those various insurance come-ons into the recycling bin. I also did a little Covid-safe happy dance.

  4. My sympathies. I’ve been on it for a while. Last year we did a major review and selected new plans. Something that annoys me about all medical insurance is the way things are categorized. I can never accurately know what something will cost. Sometimes it more and sometimes it’s less. It needs to be less complicated. Congrats to you for doing your homework. It’s painful because no one wants to spend significant time.

    1. I really don’t understand why we can’t just have one plan with specific benefits. I think it would save a lot of money (so maybe the benefits could be strengthened) and it would certainly save a ton of stress. Unfortunately, it’s not going to get easier to navigate as we get older.

      1. Something I always say to my husband after I have navigated a charge that didn’t make sense is “what do the older and less wise people do?” I managed the benefits program at my last company so I understand it better than most.

  6. Good luck, Janis. Wise advice to do your research. Private insurance companies always remind me a bit of casinos – they claim to be there for you but they make sure the house always wins.

    Deb

  7. I’m 66 and I’ve been there! It can be overwhelming, for sure. The best advice I got was to ask the doctor that I most wanted to be on my plan and hear what his office recommended. His insurance specialist was very helpful, heard my concerns and recommended an agent to talk to. It was nice to be in an experts hands. So far so good. My youngster of a husband has another year to go so it will be easy for him now that I’ve done all the homework!

  8. Janis, we used one of the local Medicare advisors you referenced. He plugged our various providers and prescription meds, as well as anticipated needs into his database and pulled up the plan(s) that fit our needs best. There is no charge for this service. His advice was golden. We meet with him every autumn to repeat the exercise and make sure we are still on the best plan for us. There is no charge for the service and he is available throughout the year if we have questions. This saved us so much time and frustration. I wish every senior knew about this tremendous service. BTW, happy birthday!

    1. We used one of those advisers too… he was great. And, even though our eventual coverage choice didn’t result in a commission for him (from an insurance company), he was happy to help. If we decide to go with a different plan in the future, we’ll definitely use him again. I agree that more people need to be aware of this service. Thanks for the early birthday wishes!

  9. Not only is it complicated but you go from carrying 1 card (as a corporate employee) to carrying 3- Medicare (A+B), Part D, Medigap unless you do Part C (Medicare Advantage).

  10. He-Man spent months getting his choices and coverage all worked out and running smoothly. I’m glad he went first through the process because when it’s my turn I’ll have experience and friends to help me too.

    1. Oh, yeah. It would make so much sense to simplify the offerings and the process, but I’m pretty sure the insurance companies wouldn’t let their politicians (and I mean “their” politicians) do that. There is big profit to be made by keeping it complicated.

  13. It is a huge pain in the butt and a waste of valuable time sorting through all of the options. When I turned 65 a couple of years ago I let my trusted insurance agent decide on my supplemental plan for me. It has saved me hours of aggravation. He sorts through the options and presents me with the best one every year. It costs me nothing for him to do the work—he gets a small percentage from the insurance company. I’m happy.

    1. I’m glad that you had a good experience. I think most of those advisors really provide a great service. I knew our guy was trustworthy when, after looking at our options, he recommended my husband’s retirement plan, a decision that yielded him a 0% commission.

  15. Great post, Janis! Love the shoutout to those in other countries who I’m sure look at our healthcare system with jaws figuratively dropped. I’m so glad you mention the need to reevaluate yearly. My 73 year old sister is starting to push back at my insistence each year that we need to review her plan. So I have to take it upon myself to do the due diligence on her behalf, confirming her network doctors, her meds, etc. That’s vital each year. Congrats on making your selection. I’m still a few years behind yet, but it’ll be coming up quicker than I realize. – Marty

    1. I hope your sister appreciates your help! I remember when my father was still alive but failing mentally and it was up to me to sort out his Medicare coverage. I was aghast at how complicated everything was… and I was young with a good brain! If he had to do it himself, there would have been no way he could have navigated it. Frankly, it seems criminal to put our seniors through this.

  16. As one of those who lives in a country that considers healthcare a right for every citizen no matter what age (so far anyway, though I’m sure our lovely U.K. govt would love to change that) I read in despair. I had no idea it was so complicated. How on earth do people cope who don’t have the education or intellectual capacity to work through it all?

    1. It’s crazy, Anabel. I sure hope your citizens learn from us and resist any changes (although, I’m sure they’d be dressed up as benefits). And, you are right, just when many people are losing their ability to understand complicated concepts, they make it more complicated.

      1. Dear Janis and Friends, “making things more complicated, ” especially adding this burden upon people who don’t have the intellectual facilities to handle this needlessly overblown confusion…once again, the powers-that-be are laughing at us little people.
        Yep, that’s how the (wannabe) kings of the earth get their jollies. Oh well, such is daily life outside of Christ.

  17. Wow. I had no idea this was the medical state of affairs for my friends south of the border. Best wishes as you navigate this particular project. And if I miss it, happy birthday!

  18. I’m not going to brag about our Universal Coverage here in Canada other than to say it does even the playing field for access to basic health care. Access, not timely access. Wait times put Canada very low in timely access compared to many other countries. Many think it is ‘free’, but it is paid for through our taxes on a progressive scale. The bottom 10 per cent of income-earners will pay $470 dollars a year while the top 10 per cent will pay almost $40,000. Many things are not covered – like dentist, optometrists, physiotherapy, ambulance and prescription medications. People buy insurance to help pay for those services. We are starting to get more private providers who bid their services to the government as well as providing service to those who wish to pay for a service. Canadians also opt to get timely health care by paying for it in the United States. (A friend of mine did that for a throat cancer diagnosis…)

    1. I understand that Canadian healthcare is not free (some people in the US think that Medicare is “free” also) but my research indicates that the overall costs are lower. Even if it was the same, I think I’d prefer a system that views healthcare as a right not a privilege. It always seemed odd that most plans in the U.S. don’t consider teeth or eyes as part of the body and therefore, not covered at the basic cost. Interesting that some Canadians come to the US for treatment, as many in the US go to other countries for theirs. It does seem like there should be a better way.

  19. Happy upcoming birthday, Janis –
    I’m proud to be one of those people you mention who lives in a country (Canada) with Universal Health Care access. In our particular province (BC) for basic Universal Health Care protection, we pay $0. People wishing additional coverage such as dental, some prescription and some physical therapy over the prescribed limit may purchase that insurance separately – but I have been very satisfied (knock on computer) with what has been provided to me.
    The Canadian government is now looking at providing a Universal Plan to cover all drugs. I remain incredibly grateful for all of this.

    1. I’m glad to know that you are satisfied with your healthcare system, Donna. I’ve heard almost 100% good things about Canada’s Universal Care and I know you realize how lucky you are to have it. I don’t know how things got so messed up with our system (although it probably had to do with money and lobbying) but at least I will soon reach the age where I’m covered under Medicare. Now, I’ll do my best never to have to use it 🙂

  20. You’re on the right path – We’ve been on Medicare for a year and this was our first time to ‘renew’. It’s still beyond me why as we need more care as we age, we also have to be more alert to the ‘proper’ coverage we sign up for!!! Geesh.
    Happy New Year, lady in San Diego!

  21. Personally, I detest our healthcare system. I think it should be run like our electric co-op. The people who work in healthcare would still make good money, but there is not profit motive involved. Private health insurance is a joke. I will be uninsured until I reach Medicare age (a ways to go yet!). In the meantime, I pay as I go, and feel I get better care, too. Healthcare providers look at me, not their computers, and I have more say in my treatment. I know that will change once I’m on Medicare. I’ve watched my husband go through losing provider after provider.

    Well, best wishes for your birthday and continuing good health!

    1. I can’t disagree with anything you’ve said. I know a couple of people who have gone “pay-as-you-go” and it’s worked well for them. As someone who had an unexpected and serious illness at a young age, I don’t think I’d feel comfortable doing that. Even though I’m completely recovered, I know that bad (and expensive) things can happen to even healthy people. It’s so distressing that healthcare coverage isn’t something that is available to everyone automatically.

  22. Hello from Australia from a gal a fair few years older than the basic age group talking here. Having been thru’ cancer, heart problems etc I am quite frankly hugely happy writing from here. Some of my US friends had spoken of ‘trying times’ – I had no idea. Basically all necessary healthcare is free here and, since I am over 65, so is the ambulance. It is so for the younger generation also if one just earns the average wage. Almost all necessary drugs are $A6.80 per usually monthly script . . . past about $A200 spent per year they become totally free. Yes, I did choose to take out private insurance. There are some 6-8 main providers – one certainly does not need anyone to explain the rules and regulations: these are clearly and simply put down . . . but each company does have street side offices in the major suburbs with a friendly counter staff to explain and advise . . . they often suggest you go visit their competitors also so you are happy at the end. I could have saved the money, but I wanted to pick my hospitals, have a private room if I did not feel sociable, pick all my own doctors etc. Also one is often able to have 1-2 more days in private for recuperation. The private insurance also pays towards dentistry and my optometrist which are also not free here. Variably, according to your contribution, you have all kinds of auxiliary care included, eg physiotherapy, massage therapies, ayurvedic care, exercise classes etc. Age 65 does not make an iota of difference, except some people may choose to retire and will thus no longer contribute their little bit out of their salaries. No one likes becoming ill . . . unless one comes to suffer from some very unusual disease ‘not on the books’ or needs to go overseas to be treated, money simply does not enter the equation. Thank God.

    1. Thank you so much for writing such a great overview of Australia’s healthcare system! It all sounds very reasonable: basic care for everyone, bumped up care for seniors, and the ability to add coverage with clear, understandable, reasonably-priced insurance. As I’ve said prior, I have no idea how our system got so messed up, but it appears there are plenty of examples of well-run systems out there. I keep hearing that “we have the best healthcare in the world” HA! The people who say that either haven’t found themselves in the system (they just go to their regular doctor for check-ups) and/or they haven’t researched what other countries offer. You have much to be grateful for!

  23. Although I just turned 61, and have time to think, using an advisor seems the way to go from the comments I’ve read, Janis. Currently we’re in a health care situation that is not great since my husband retired from a public agency and was carrying my medical. It’s way too complicated to explain here but let’s just say our out of pocket monthly payments to continue Kaiser is in the 4 digit range! Hans is likely going to work and should get some medical. Staying healthy and accident-free is our goal. I will look forward to Medicare.

    1. Yikes, Terri! So many people have also lost their coverage because of lay-offs due to Covid. It’s such a tragedy. Maybe the current situation will be a wake-up call to everyone that healthcare should be a right, not a privilege. I hope that you’ll be able to get insurance through work soon. In the meantime, stay well!

  24. Health care is such a good (and touchy) subject, Janis! As a Belgian – and recently turned US – citizen, I have always raised my eyebrows at how inefficiently and expensive health care is “ran and managed” here. It’s a business! Weirdly enough. It’s not about the patient or their health. It’s about money. Just like so many things in this country. But, I digress.

    What boggles my mind and bothers me most, to be honest, is that we – at any age – have to keep changing our plans almost yearly, because one or another issue, cancellation of “the plan”, our income level, or status change. It’s been insane! And, with a change of plan comes a change of providers and doctors! Huh??

    Wouldn’t it be nice to have a national health care plan? Mark and I ran around Tucson for five (!) hours about a week ago, before we found an urgent care faculty that was willing – and able – to accept his MA insurance and could see him! Crazy… Yet, a few years ago in California this was trivial.

    Good thing you’re doing your research and I agree with everything you mention in your post!

    1. I think that many people in this country think our system is just fine because they have coverage and they do little else but see their doctor now and then. Once someone loses coverage, finds their coverage inadequate, or researches what other countries have vs. what we have (and how expensive it is), they realize just how crazy of a system we have. And, having to navigate the craziness every year!

      I hope Mark is doing well and got the care he needed… five hours: that’s nuts!

  25. Congratulations on your upcoming birthday, Janis. I’m glad you found the insurance that fits your current needs. I have a few years to 65. I will definitely be using an expert to help make that important decision. Here’s another site with some good information https://www.srbenco.com/.

  26. Thanks for the heads-up and tips, Janis. We have five more years, but we don’t look forward to the decision-making. I can tell we’re getting older because as we want to move out of CA when we retire, our desire is to stay close to Kaiser. 🙂 Kaiser has been great to us, so we really don’t want to leave that comfort zone. Sigh. We shall see and I agree with you about the best healthcare plan. Wishing you all the best in this new venture and a brighter new year!
    ~Lauren 💗🥂

    1. I’ve been with Kaiser off and on (off now) and also was pleased with their one-stop-shop care. They are in other states, but certainly not all. I wonder if the states that don’t have Kaiser have something similar? Thanks for the good wishes… I’m so happy to be done with the decision making… at least for this year 🙂

      1. Glad you have it all figured out too. And we’ve already done research as to the states Kaiser is offered. We’re not ready to move yet, so we’ll see how things pan out. Sure wish it was simpler though. 🙂

  27. Though we have a public health system it isn’t up to standard to cope with our aging society.

    We had extra health insurance as did our parents. As soon as we hit our fifties it became too expensive and far more cost effective to save and keep money aside.

    Well done Janis to you for spending the time as Anabel pointed out what about all those who don’t have the skill or any insurance? A harsh reality for many. I must admit I find Americans healthcare system very hard to comprehend.

  28. Happy upcoming significant birthday! As a Canadian this is one area where I am so grateful I don’t have to put a whole lot of time & thought to. Very important for you to be informed and knowledgeable about which plan you chose 💕

  29. What? You’re turning 65?? Mark just went through this. Sounds like you need a degree or something. Thanks for sharing the information site.

  30. I can sympathize! My husband turned 65 this year, and we were inundated with calls and mail wanting to sell us a medicare supplement. Never mind that he’s not retiring and plans to stay on his company’s excellent plan. (The thing I do like about private insurance is the ability to choose your own doctor and change doctors if you need to. We found out the hard way just how important that privilege is, and I dread losing it.) Hang in there! I know the information is so confusing!

    1. We’ve decided to stay with my husband’s retirement healthcare plan for many of the same reasons. It’s more expensive, but gives is greater flexibility. We figure that, as we get older, we’ll be seeing more specialists and having the option to choose who we go to will be important.

  31. Just the other day on the radio I heard something about how people can call some number and talk to a Medicare “Decomplicator.” I had to laugh at that job title, but also shake my head that it has to be so complex that it needs to employ “decomplicators.”

  32. Thanks for all the good info, Janis. I will turn 65 next January. Because I am a retired teacher, I think my first step is to contact the company that handles teacher pensions in my state. They help us navigate Medicare and other insurance plans. It’s definitely a tough puzzle to solve.

    1. My father worked for the local city school district as a psychologist and, as I remember, they made the transition pretty easy for him. Of course, that was many years ago so who knows how complicated it’s become by now 🙂 You have a whole year so there’s lots of time to solve that puzzle.

  33. Thanks for your info Janis. I will join the “65 club” in April. I am going to use the same insurance company I’ve used since I have been on Obamacare and they have an guy at their company who specializes in Medicare. He sent a postcard to me in October that said “you’re 64 1/2, let’s get together soon okay?” Good thing I didn’t mind advertising my age to the world and yes, the mailers are non-stop aren’t they? This service is free and I’m glad I found it for Obamacare because I found it frustrating to navigating through their site. I would have been willing to stay on Obamacare a while longer, but I guess this is forced on you.

    1. Yep, as they shovel lots of choices on to you, they take others away. It’s great that the specialist is proactive. Three months before and after your 65th birthday to make a decision sounds like a lot of time, but it goes by fast! Have fun 🙂

      1. I didn’t realize that Janis, so I’m glad I can be spoonfed to make the best choice and he does the application right during our phone consult. I didn’t realize you have the leeway of three months’ time after your 65th birthday too. Happy New Year!

  34. I also turn 65 in 2021 (April) and have been getting all that stuff too. I’ve also just finished reviewing options for my parents so I feel pretty informed. They were happy with their Advantage plan until this past year when my mom had her brain injury. We met with our local SHIIP counselor who told us Advantage plans are great until you get sick. Then you pay for all those years of $0 premiums. My husband just retired from USPS and we’ve continued with the federal employees health insurance. My plan is to sign up for Parts A and B and use this insurance as my supplement. We get dental insurance through my retiree plan. I worry at times that this sounds too easy but I do know, after dealing with my parents’ coverage, I am not going with an Advantage plan. My dad has commented several times that he couldn’t deal with this without my sister and me now that he’s older and unable to process information like he used to.

    1. You bring up such a great point! I think a lot of people are attracted by those low – or $0 – premiums and blindly choose an Advantage plan. Something that many people aren’t aware of is that, if they initially sign up for an Advantage plan, then decide to switch to regular Medicare, in many cases, they won’t be able to get Gap insurance without a physical. And, at that point, the Gap insurer can either deny you coverage or charge a high premium. The research that you’ve done will serve you well. Thank you for your great comment! Good luck!

  35. Great observations about American healthcare and the various ways of paying for it (or not.) I found the Medicare maze so utterly confusing that I ended up going to an insurance broker. First one I went to confused me further. The next one listened to what I thought I wanted, asked some key questions about my health, my lifestyle, and pulled out two comparable plans for me to choose from. I’ve been very happy with my choice so far, and it has saved me a good deal of money compared to what I would have done, had I not talked with an expert. Each year he contacts me to let me know of any plan or option changes that I need to consider. So, why do they make this insurance business (actually the business of paying for medical care) so confusing and convoluted that there is room in the budget for brokers? That just adds another layer of expense…not directly to the purchaser, but that cost is written into all the plans. It is so silly. This is not how we got to and walked on the moon.

    1. Exactly! Why is it so complex that we need “experts” to help us make sense of it? I really worry about the day that my husband and I aren’t able to decide what’s best for ourselves. I do appreciate the “free” help, but I’m skeptical enough to question where their loyalty truly rests.

  36. Congrats on being proactive in your Medicare planning. The insurance companies sure can make it confusing and enticing at the same time. My dad calls me every year wondering if he should change something or not. And he doesn’t have a computer to help him, only TV commercials. Your last sentence sums it up nicely – Good luck and stay as healthy as you can. The best healthcare plan is the one you don’t have to use! PS – Happy Birthday too!

    1. Your dad is lucky to have you help him. I wondered about so much being online now. Older people – those who are the most vulnerable – are often not computer savvy. I was happily surprised to find that Medicare has a good information service by phone. They answer right away and the representatives seem to know their stuff.

      1. I’m glad he calls me, and I’m thankful that he listens and calls his insurance rep for help too. That’s good to hear Medicare has phone help that is helpful. I feel for those who are isolated and not computer savvy.

  37. Janis, I danced a jig on my 65th birthday. To be covered by Medicare and the supplemental plan I chose is a very welcome change to the high cost of insurance premiums. I am a healthy person, but I go for an annual physical, mammogram, lab tests, etc. and have one medication prescribed – all at no cost to me (except the taxes I paid for years to keep Medicare alive). Even my gym membership is covered. It is a hassle to sort through the plans and options, but that’s where it helps to have a good insurance agent who can provide guidance. Hopefully, our new administration will iron out the kinks in Obamacare and present something that works and is affordable for everyone. That said, I am not naive to the fact that fraud and corruption will be as prolific in that arena as it is in the insurance industry.

    1. On January 1st, when I was able to begin Medicare, I felt a sense of relief too. I had good insurance before but I always felt that it was less assured. Even thought tweaks can (and, probably will) be made to Medicare, my fingers are crossed that those of us already on it will be grandfathered in. I truly hope that our feelings of comfort regarding our medical coverage will someday be felt by everyone… no matter what age and condition of their health.

  38. Janis, I thought I had read all of your posts until today’s discussion. I don’t want to miss out on any news from favourite bloggers. I made myself a note to recheck your posts.

    I told Chuck today how I was not aware you had turned “a certain age.” I thought 5 to 8 years younger. You make a great point of educating ourselves to make informed decisions. Your last paragraph shares a great deal of wisdom.

    1. Reaching 65 surprised the heck out of me too! I know that you are grateful for your country’s healthcare system and you should be. Not only is the Medicare system complicated, certain politicians also love to use it as a negotiating tool. I’m just going to try to stay healthy so I don’t have to use it 🙂

  39. Janis, I’ll be turning 65 this year too and as a Canadian, I’m grateful that I don’t have to sort through health coverage options. My free universal health care (paid for by everyone’s taxes) just continues on.

    Jude

  40. I am certain you have heard enough from your Canadian friend bloggers about how much less we worry in CAnada planning for health issues at retirement. Just be aware that dental care is not “free” under our public health insurance system nor various allied health services. If one is low income (pretty low), there’s limited physio visits, counselling, etc. Better than nothing. I am on an international cycling forum with mostly Americans. They worrry alot about the right time to retire re giving up employer health care benefits.

    While there’s some thought by some close to retirement CAnadians, CAnadians are less obssessed about being bankrupt. There are extra costs for wheelchair, mobility aids, certain drugs, ….but not as shocking as what Americans must pay for monthly premiums, illegal billing by private insurers, etc. I concur that we do pay more taxes…but there are long term benefits and lessening of stress for major life events.

    1. I’m sure they are out there, but I have yet to meet a Canadian who isn’t grateful for their national healthcare coverage. I would happily pay more in taxes to assure that every American had healthcare coverage. Having everyone contribute to the cost through taxes makes the overall cost go down for everyone. It does seem odd that, for some reason, dental coverage isn’t considered “medical” in Canada or under our Medicare program here. Thank you for adding your comment to the discussion!

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