So you are turning 65 and have questions?
Many seniors turn 65 and are inundated with Medicare material and advice from friends. It is not easy to decide what to do about Medicare, especially with all the plans available in Nevada. Listen to what your friends say but take the information with a grain of salt because what’s good for your friends might not be for you and vice versa.
There are many decisions to make before you take Medicare and you might as well have these answers before making a decision.
- How long do you plan on working?
- Do you need Parts A & B or just A? If you work for a company and plan on continuing working does the company have more or less than 20 employee? If less than 20 employees, you must take Parts A & B because Medicare pays first. More than 20 employees and the group plan pays first so you only need Part A. If your employer has less than 20 employees and you don’t take Parts A & B, you are facing a lifetime penalty. Think twice before you go down that road.
Once that’s determined it’s now time to consider the various options you have with Medicare. You can read all the material you have received or talk to friends or relatives but to get accurate answers you need to speak to an experienced Medicare broker who knows your area and the plans offered. This is a complex decision that can affect you for the rest of your life so getting it right the first time is critical.
So you finally decide to meet with an experienced Medicare broker, what should you ask?
- First explain how long you plan to work and the size of your employer.
- Then talk about your current insurance so the broker understands your situation.
- Discuss your medications, including the dosage.
- Does your current Doctor(s) take the plan you are considering? Do all your Doctors take that plan?
You’ve given him/her the complete picture, so now ask for their recommendations and why?
They should explain the various options so you can decide what you want and can afford. Depending upon your decision it could be a final one because some of the plans cannot be changed because you have to prove you are insurable.
In Nevada, you have Original Medicare and a choice of 24 drug plans. You can also choose a Medicare Advantage plan called a MAPD which is available in either an HMO or PPO. There are 7 HMO plans and 5 PPO plans. Then you have 10 different Medicare Supplement plans which require a separate drug plan. So when you add them all up you are looking at 46 different options. Mind boggling isn’t it? That’s the real reason you need an independent broker to walk you through the maze called Medicare. There is just too many options to figure out yourself.
The next step will help you eliminate some of the options. Determine if all your Doctors take the plan? Then determine if all your medications included with the plan? If not, determine what’s important and eliminate any plan that doesn’t cover your minimums. That could mean changing a Doctor or changing medications. Are you willing to do that? Please remember this could be a lifetime commitment if you take certain plans. The reason I keep mentioning the lifetime commitment is if your chose is a Medicare Supplement, in order to change to a different supplement later on means you have to qualify medically. The MAPD plans do not have that requirement.
Once you’ve gotten this far, determine if the HMO or PPO will meet your needs? If not, then the Medicare supplement might be your best option. If that’s the case, can you afford the monthly premium, now and when you are no longer working?
There are many things to consider before you make a decision. Review them carefully so you make the best decision for yourself. Another tip is that you can apply for Medicare 3 months before your birthday, the month of your birthday and three months after your birthday. That gives you 7 months to figure it out. The longer you delay, the further out Medicare makes your effective date.
There are 2 other issues to consider.
- If your birthday is the first if the month, your Medicare starts one month earlier.
- If you are already collecting social security, they will send you your Medicare ID card. If you are not taking social security, you must initiate getting Medicare. (Very easy, 3 months before your birthday go to ssa.gov/Medicare. About 3/4 down the page is a button called Apply for Medicare only. Hit that button and it takes less than 10 minutes to sign up. All you are signing up for is Medicare Parts A & B. Then the fun begins trying to decipher which plan or plans to meet your needs.
Medicare is difficult to understand so choose a Medicare broker who knows the answers.
The Barend Agency Inc.
Len Barend. Broker