Turning 65? -What To Know About Medicare
Retirement age used to be simpler. At age 65 you figured you would start collecting Social Security and begin to be insured under Medicare. You were expected to retire from work and, with your gold watch and farewell party, everything was set.
Today you might begin to collect Social Security for most applicants at any time from age 62 to age 70 with full retirement age for those nearing retirement now at age 66. Medicare and Social Security are not necessarily in sync. If you are just now approaching age 65, and wonder how your ensuing age works with Medicare, you probably could use some guidance as below. Remember to get expert advice if you need it.
- Basic things to know for persons turning age 65. If you are still employed and receive health insurance through work Medicare Part A could be your primary or secondary health insurer depending on the size of your employer. Whether Medicare B for out-patient doctors, medical supports and equipment, and Medicare D, for prescription drugs is needed depends on whether you have a creditable plan at work for these. If you do not know the answers, check with your HR department or someone who does know.
- If you need to sign up for Medicare because you do not have equivalent coverage through work and are turning age 65 you have a window of time during which you can make your choices. For people who are turning 65 and are retired or do not have the needed employer related health insurance, it is especially important to make timely choices on Medicare B and Medicare D because there are penalties for late enrollment.
- Choices you initially make could lock you in later. On turning 65 or on initial eligibility, you might choose a Medicare Advantage Plan (an HMO, PPO, PFFS) or a Medicare Supplement (Medigap) with Medicare or you could simply have basic Medicare. A Medicare Supplement is Medicare plus other private insurance coverage. Medicare Advantage is through a private insurer. If you choose a Medicare Supplement when you are first eligible, you will not have to go through medical underwriting then or later. If you choose a Medicare Advantage Plan and later want a Medicare Supplement, you will likely have to undergo medical underwriting to change. What this means is, if you first chose a Medicare Advantage Plan because it is less expensive and your health deteriorates later, you may not be able to get a Medicare Supplement later. So the safer choice, if you can afford it, might be to start with a Medicare Supplement. You can switch from a Medicare Supplement to a Medicare Advantage later without underwriting.
- Open Enrollment is for Medicare Advantage Plans (HMO’s, PPO’s, etc.) and for Medicare D (Prescription Drugs). If you are already on Medicare and want to change your Medicare Advantage Plan or Prescription Drug Plan (PDP), then the open enrollment period to do this is basically from October 15 to December 7.
- All Medicare Supplement (Medigap) Plans With the Same Letter Have the Same Coverage. Differences between companies are in the servicing and cost. If you buy a Medicare Supplement Plan from United Healthcare, for instance, and you compare it to a Medicare Supplement Plan from Humana, as long as it has the same letter (Medicare Supplement “F,” for instance, Medicare Supplement “G” or Medicare Supplement “N”), it has the same coverage. Therefore, the differences are whether you believe the company has good customer service and how much it costs. If you want to know what each coverage is by the letter, check out www.medicare.gov.
- There is a wide diversity of coverage among Medicare Advantage (HMO, PPO, PFFS) plans. If considering a PFFS plan, you should realize that they are not all accepted with all medical providers who take Medicare.
- Medicare Supplement plans and Medicare Advantage plans handle prescription drugs differently. Medicare Supplement plans do not themselves have prescription drug coverage but are often marketed with a separate PDP or prescription drug plan (look for PDP or Rx on the card). Medicare Advantage plans usually come with prescription coverage.
If you are confused, get help. The Chester County APPRISE program staffed by volunteers, is excellent. It can be contacted at 610-344-6035 or check with an elder law attorney or insurance agent who works in this field.
About the Author Janet Colliton
Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.