Lesson #12 – Medicare …. WAIT!! Isn’t this for OLD people?

 

Medicare!  Nothing is simple until you actually understand it all.

At the age of 64 we start receiving lots and lots of mail from every health insurance company known to man.  It is unbelievable how the insurance industry really wants YOU.  And they know you are 64.  They want not just YOU but your money each and every month.  Health insurance companies that you, perhaps, have never heard from.  Lots and lots of mail.

This happened to me.  I wondered why I was getting all of this unwarranted attention.  I was covered by my husband’s health insurance and I was very happy.  I am sometimes not quick to the draw.  Actually, a lot. Dawning of a new day begins. It’s a shock to the system.

Reaching the real retirement age of 65!  Woo Hoo.  Medicare!  At 65  we are eligible.  Not really something to be thrilled about…this getting older business… but a lot of attention and time must be spent figuring out what works best for you in the health care department.

You can enroll in Medicare prior to turning 65.  I would suggest doing your homework, deciding what plan works for you and enrolling before your 65th so that when you turn 65 you are off and running.  I’m unsure why I found this process so complicated and, believe me, I spent hours reading and thinking about it all.  I mean, I used to take care of choosing the best health plan for my employers, reviewing insurance claims, policies, etc. for them.  I took care of all the attorneys’ claims….can you imagine?  YES, I understand because it is paperwork and WHO in their right mind wants to fill out paperwork?  Everything ‘in the old days’ was completed by hand and mailed.  Glad those days are behind me.

There are two directions you may go.  Enroll in the government Medicare or a private health insurance company also called a Medicare Advantage Plan (much like a HMO or PPO)  It’s important to know what Medicare covers.  I am not writing details but this is an overview only.

The original Medicare covers Hospital-Part A and Medical Insurance-Part B.   The Advantage plan is PART C and it combines Part A, Part B and USUALLY PART D (drugs). Decide whether you want government Medicare or a private insurance Advantage plan.  The Advantage Plans are offered by insurance companies in your area.  You will receive information from AARP, Humana, BCBS, etc. etc. Find out what these insurance companies cover for you.  This is the beginning and Decision 1.  Once I understood it all I chose to be on Medicare.  It was simple once I got it.  With Medicare you can go to any doctor that takes Medicare anywhere in the United States.  So you can be in California and become ill and all you have to do is find a doctor/hospital that takes Medicare.  Most do. It’s more complicated with the Advantage plans.   Some are only taken by doctors in your area zip code or your State.  A plan may be accepted in another State but not all and you  have to find a doctor that takes that insurance plan.  I don’t have the patience.  When we travel I want the peace of mind knowing I can go to a doctor that takes Medicare.  This doesn’t work overseas and that is another story.

Second decision. Drugs. If you choose a Medicare Advantage Plan, find out if the plan includes drug coverage.  Part D.  Most of the Advantage Plans do include the prescription drugs plan.  If the plan does not include drug coverage, check if you may add it.  Some people may like the complete package with everything included.  It all depends on the drugs that you are prescribed.

A drug plan is necessary to purchase if you choose to go the Medicare route like I did.  It is called Part D.  If you don’t take drugs, you don’t need this.  You may sign up next year during open enrollment if your drug usage changes.  Search by price.  I was told that all drug plans are the same and it is regulated.  True?  I think so. So, shop by price but just make sure the drug plan does cover your drug.  If you can take or may switch to a generic you may save money in the long run. Find out how much the drug coverage company charges for your drugs.  If you move, you will have to do this again.  Go cheap..  I pay $0 for one drug per month and the other is not much more.  Your monthly premium with different companies is all over the board.

Now, this is IMPORTANT.  Third decision. Again, if you choose to go the government Medicare route.  You only have one opportunity to choose to take the Medicare Supplement Insurance plan (MEDIGAP) which means you don’t have to pay any out-of-pocket expenses for anything or significantly less depending on which plan you choose.  You do, however, have a deductible.  If you don’t take a plan when you sign up, you will never NEVER never have any other opportunity to sign up for it.  NEVER.  I decided to take the plan because I may not need it now but in the future I might.  I don’t want to pay out-of-pocket for anything including copays, etc.  Don’t miss this.  It is so important.  I feel it is better to pay now for something I may need later.  If you don’t agree then don’t get the MEDIGAP policy.

There are ten MEDIGAP plans to choose from.  Some or all will be offered in your State.  Some of these plans cover 100% of the gap left between Medicare and you.  If you don’t buy into the Gap plans you will have to pay out-of-pocket for care that Medicare does not cover with both Part A and Part B Medicare.  Hence, the name MediGAP.  Some of these ten plans pay most and one pays ALL of that gap so you NEVER have to pay out-of-pocket.  I chose a plan that has a deductible of $147/year.  Paying for the plan that covers 100% of all of the gap was more than what I would pay for the deductible.  That worked for me.

With the Advantage plans Medigap may not be sold to you.  This was a negative for me.  The Advantage plans may gear their coverage to cover gaps so no worries there but to be honest I am unsure.  Ask those insurance companies about this.

Medicare is taken out of the Social Security checks automatically so you will be getting paid less every month.  Easy.  You will have to pay each month for your drug plan and your supplement plan.  I just set it up with my bank to send every month just like any other bill. Every year the premium may increase and it is a good bet the premiums WILL increase every year.  Just accept it and pay.

If you move you have to let the plans know about it to see if they can cover you in your new zip code.  The premium will change for that also.  Accept that too and pay.  Nothing we can do about it.

When there is a move, however, you have a certain number of days to ‘shop’ again.

Easy to sign up.  Call Social Security or medicare.gov.  You can enroll in the Advantage plans, of course, by calling that insurance company.   Either way call several months prior to your 65th birthday.  You will receive the Medicare card/drug prescription card/Medigap card in the mail.  Carry them all with you as normal.

So far I am happy with my choice of Medicare, the supplement and the drug plan.  I have found most of my doctors take Medicare.  Not so with my GYN.  She decided not to take it because the amount of paperwork and the wait time to be reimbursed by the government is lengthy.  I was going to her for over 20 years and I was sad to say goodbye.  She may be getting ready to retire since she is my age.  My deductible has been met this year and I don’t pay anything to anybody for doctor visits.  Nice.

Contacts to remember:

http://www.medicare.gov/find-a-plan for information

1-800-633-4227 Ask for agent.  Help is there.

Most States (Georgia and North Carolina) have people to help.  I can’t speak for other States but imagine there is help. Georgia has great help ‘GeorgiaCares’ 1-866-552-4464.  One on one help.  Invaluable to me.

If you have any questions call the numbers above.  Good luck with this!!  I have made this as simple as possible.  Let me know if I have forgotten anything.  I would appreciate it.

Leigh 

 

Lesson #11 – HELP! I’m Drowning #2 !!

Hi all!  I am republishing this blog since my husband just swam again in this particular meet in Myrtle Beach (South Carolina Masters State Championship).  Wow, where did that year go?  He came in first (I say proudly) in his age group for the 200 IM and the 400 IM.  Woo Hoo!  And he came home with a beautiful award for his team (out of State) coming in second.  I was the counter again for the 500 free and the 1650 free (66 laps!!) and I didn’t mess him up.  I am getting the swing of it.  Next year maybe I won’t be so nervous being the counter!  I still don’t swim.  Maybe by next year things will change!  Oh and P.S. the oldest woman there at this meet was 85 years young.  I’m sure her family is so proud of her!

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Swimming. Recently, I accompanied my husband to a South Carolina State swim meet in North Myrtle Beach, SC.  He asked me to be his counter for his 500 yard swim.  Twenty lengths…..of freestyle…..in a standard 25 yard pool.  I say this because if you are anything like me, I don’t remember what a lap is or, rather, how far a lap is in a ‘normal’ racing pool.    There is a lot about this sport that I don’t understand.

So, to be a counter you put the counter board down under the water so the swimmer may see how many laps he or she has completed.  I suppose when you swim/race twenty laps you might forget how many laps you have swam (or swum?)…..Yeah…..I guess so!  So with each couple of laps completed the counter has to flip the board showing two more laps completed.  Then, again, push the board back under the water to be read.  You get the idea.

I didn’t mind doing this for my husband … no, not at all.  However, I was concerned that I wouldn’t be able to stand up afterwards because the pain in the knee hasn’t gotten any better.  One, because as much as I try, arthritis just doesn’t disappear when I want it to and two, I haven’t lost that knee hurting extra weight I carry around.  Geez.  I am working on it….slowly.  No need to rush.

Counting was successful and I didn’t screw up!  I put the correct number of laps on the board and pushed it under the water for him to see.  Success!  I have to say I was the ONLY counter NOT in a bathing suit.  I was fully clothed with sneakers on.  Boy, I felt sooo out of it.  A word in my defense.  It was very cold out.  The northeast was being snowed upon again and people were shoveling out of two feet of snow.  Myrtle Beach was cold but minus the snow.  I was dressed appropriately for the weather.  These swimmers were not.  The problem was when I was finished counting I was also soaked from my waist down.  Cute.

Impressed was I of all those swimmers.  Remember the days when we were very embarrassed to be in a swimsuit in front of our friends or help…. boys?!!  Watching these swimmers walk around in racing suits, no shoes, and dripping wet, I found I was admiring them all.  In attendance were all shapes and sizes and all ages of people.  The Masters swimming program includes anyone 18 and over and these meets include everyone.  When you sign up for a meet the swimmer writes his best time for a certain event and that swimmer is put into the appropriate ‘heat’ swimming against others in various age groups  with approximately the same race time for that event.  There were many retired folks at this meet and it was for those people who I gained a newfound respect.  Men with one or two too many beers, women who had passed their prime figure years and many who obviously had one or two hip replacements, knee replacements, hernia scars…..etc.  In this particular meet there were swimmers close to 80 years old. Amazing to me that there was no embarrassment or hiding of stomachs or legs with cellulite!  Amen!   Some older bodies were in great shape but I will guess that those people would have great bodies regardless.  ‘They’ say swimming is the best exercise when we reach, ahhem, retirement age.  Come to realize that retirement doesn’t mean having to be embarrassed about aging and having an older body.  Thank goodness. How wonderful is this?

There are approximately 60,000 members of the US Masters Swimming program give or take.  There are meets throughout the country and in almost every State of the Union.  Members don’t have to race others in a meet but might just be happy being a member of the Masters in their local towns…. joining a club with those having the same interest.

My husband has tried to encourage me to join the Masters and swim in a meet.  He tells me I could do the backstroke and win a lst place ribbon.  Really?  Backstroke?  The last time I swam backstroke I hit my head against the pool and I saw stars.  I wasn’t paying attention.  More importantly, the last time I swam a race is when I was probably 15 years old.  It was in the ocean off of Long Beach Island, New Jersey.  There were about 15 of us.  God only knows why there was a race in the ocean.  I don’t remember anything except hearing someone say ‘Go’ (could have been a pistol maybe I suppose or a foghorn) and I started swimming out to sea.  Don’t remember how far I swam but I do recall when I stopped I was far from the beach.  I kept thinking that I should be finished this race so I just kept swimming and swimming.  The other participants were finished and were on the beach.  No one looked concerned about me being way out in the ocean. I obviously overshot the race end and  I felt like a jerk the way a young person can only feel when they did something foolish in front of their peers.  I swam in and to my utmost surprise I had brought home the silver!  I still have that medal.  What I also still have is that feeling of being a jerk while trying my best to be cool.  Thank goodness I don’t have to show my ‘coolness’ anymore.  Definite benefits being part of the golden age.

I was once a serious runner and now I am very serious about walking.  Not swimming.  In another life I will swim but I will begin at an earlier age.  Not 65.  Of course NOW is the time to begin new adventures and start something new.  Did I say that? I don’t know but swimming against others who probably swam in school and understand that the pool is a 25 yard length.  Missed opportunities?….maybe there is hope.

Maybe I will change my mind.  Maybe.  But first I have to lose some weight to look better in a bathing suit.  A girl has to have some self respect.

Leigh