Navigating the Medicare Maze

Those of you who live in a country that believes ensuring adequate healthcare for all of its citizens is the right thing to do, may find this post puzzling. Feel free to gloat.

Recently, my husband became eligible for Medicare. After 64 years of being either covered by his parents’ healthcare plan or the one provided by his employer, his upcoming 65th birthday presented him with a dizzying array of healthcare plans and options – often with similar descriptions and letter designations – that he needed to choose from. Adding to his stress was the knowledge that he had a limited time window, a wrong decision now could be costly in the future, and, since my healthcare coverage is tied to his through his work until I turn 65, his choice directly affected me.

Even though my husband had officially retired from his company over six years ago, he continued to receive our healthcare coverage through them. With his impending birthday, he had to decide whether to switch to the company’s over 65 retiree medical plan or opt-out and dive into the Medicare pool on his own. There were pluses and minuses with both options, but, once we realized that leaving his company’s plan would force me to find coverage on the costly open market, we decided to stay.

Despite remaining under his company’s program, he still had to decide which plan they offered was best for us. I won’t go into all the details but, again, each option carried with it a set of consequences, and it wasn’t always apparent what those might be. We found ourselves trying to predict the future, including aliments, health challenges, and even if and where we might move at some point. This is one of many instances when navigating the Medicare maze, a crystal ball would have come in handy.

And, we are among the lucky ones.

We have healthcare coverage that we can afford and that is fairly robust. We are currently in good health, and we have the mental acuity – with a lot of research and careful reading – to understand the options offered and the possible ramifications of each choice.

We also know that can change.

The company or the government can – and most likely will over time – tweak the plans, and probably not to our benefit. We will most likely face health challenges as we age and our capacity to read and understand complex subjects and make sound decisions will probably fade over time. All of these likely progressions will impact our experience accessing Medicare.

It has been a month since he officially became a card-carrying member of Medicare. We are confident hopeful that we have made the right decisions for our situation. The financial penalties for non- or delayed-decisions (and there are a few so be careful) have been avoided. And, we have set things up so that we can make desired adjustments once I reach 65.

If you, or a loved one, turns 65 soon, I encourage you to start doing your homework now. There are many decisions to make and missing certain deadlines can be costly. If you haven’t already, soon you will find yourself flooded with mailings from various insurance companies and organizations that offer guidance (some better than others). 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. Most areas also 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.

Building a bridge to Cuba

Although the news wasn’t a surprise, I was heartened to hear President Obama announce the formal re-establishment of diplomatic ties with Cuba. This breakthrough came after months of secret talks between the nations followed by his acknowledgement last December that the relationship between the two countries was headed for a profound change. This Monday, the Cuban flag was raised over the country’s newly restored embassy in Washington, DC.

In 1961, the United States enacted an economic embargo with the explicit purpose of ousting the Castro regime. The sanctions were tightened even further in 1996, again in an effort to unseat Castro. History has shown us that these restrictions haven’t attained their goals; the Castros are still in power and democracy has eluded the island’s citizens.

Political billboards are common in Cuba. This one translates as "The great homeland that grows."
Political billboards are common in Cuba. This one translates as “The great homeland that grows”

Although past U.S. administrations have sought to moderate or remove the sanctions, politics has, until now, stymied any efforts. Politicians seeking the votes of the large population of Cuban exiles in the swing state of Florida have been unwilling to support any changes.

There are many reasons why what seemed impossible before, now appears to be happening. For Cuba, their two main benefactors, first, the Soviet Union and then, Venezuela, imploded, leaving the government without critical economic support. Tourism, trade, and investments from the United States will offer them much-needed monetary infusions. For the U.S., not only have the sanctions failed to oust the Castro regime, but they have severely constrained our country’s trade and foreign policy options. In addition, with an agreement, the Cuban government will lose a powerful scapegoat. No longer will they be able to blame their failed economics on the policies of the United States.

Demographics have also played a big role in the softening of the stance of both countries. The Castro brothers are now in their eighties and soon these powerful symbols of the revolution will be gone. In addition, the original exiles – the most vocal opponents to any change – are also aging, and younger Cuban-Americans are more open to removing the restrictions of the embargo. Although no one believes that Cuba will instantly become a bastion of human rights and democracy, it will be hard for their government to maintain its current policies when there is more freedom of communication, travel, and commerce.

Cuba's famous Malecon at sunset
Cuba’s famous Malecon at sunset

When my husband and I traveled to Cuba earlier this year (you can read about our journey here, here, and here), we found a country hungry for change. The Cubans we talked to (and there appeared to be little or no restrictions on our interactions) were friendly, welcoming, and eager to engage with Americans. Despite – and maybe because of – the hardships they face, many have a tremendous entrepreneurial spirit. They are also very proud of their country. Cuba has a 96% literacy rate and their citizens enjoy free education and healthcare. According to the World Health Organization, Cuba’s water quality is among the best in the world, as is its citizens’ nutrition levels, health, and life expectancy.

Cubans are also very proud of their medical system. Cuban doctors are highly trained and their skills are in demand around the world. In fact, some 50,000 Cuban medical workers have been deployed in over 66 nations. That, of course, hasn’t included the United States, but maybe that could change. There has been a lot of concern lately about the dearth of general practice physicians here in the US. As the Baby Boomer population ages, more and more medical care will be needed. In addition, now that healthcare is more widely available through the Affordable Care Act, we need more doctors to provide care.

I know that there are many who feel that the sanctions should remain and that formally re-establishing diplomatic ties with Cuba sends the wrong signal. I, on the other hand, think it’s time to admit that our half-century estrangement hasn’t yielded the results we wanted and has actually produced many unintended negative consequences.

Because of decades of neglect, many of Havana's buildings are at risk of collapsing
Because of decades of neglect, many of Havana’s buildings are at risk of collapsing

By joining the rest of the world and opening up relations with Cuba, we can start a dialog that could result in increased freedom for their people. It might also mean that we could help satisfy our growing need for doctors by inviting members of their highly-trained medical establishment to practice here. Wouldn’t that be better than to continue a failed policy which, after more than 50 years, has yet to show any positive results?