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.