Navigating the Complex and Ever-Evolving Medicare Maze to Optimize Choices & Minimize Costs (Part Two)

by James Lange, CPA/Attorney, Diane Markel, CPA, and Elaine Floyd, CFP

This is a continuation of December’s Medicare article. We strongly encourage you to read Elaine’s full article at www.paytaxeslater.com/medicare. Please share it with friends and family who would also benefit from the information. 

Here is more advice direct from the horsesmouth.com:

• When you turn 65, Medicare becomes the primary payer. Under Medicare, any private insurance you may have is secondary and will not pay until Medicare has paid its share, except if you have employer group coverage that covers 20 or more employees. To fully understand and implement your options, around age 64, it is recommended that you determine if you will be able to maintain your current insurance coverage after you turn 65 AND if yes, how does that coverage work with Medicare? If you are still working, or if you are retired and covered by a retiree plan, your employer or benefits administrator may be able to answer these questions.

• The initial enrollment period starts three months before you turn 65 and extends for 7 months. Medicare is automatic only if you are receiving Social Security when you turn 65; therefore, you would need to be proactive and sign up for Medicare Part A and B three months before your 65^th birthday, so that Medicare coverage can start on the first day of the month you turn 65. If you want Part D, the prescription drug plan, you would then enroll through a private insurer or through Medicare.

• If you enroll in “Original Medicare,” you will also purchase supplemental insurance, known as “Medigap” to cover out-of-pocket expenses that Medicare does not cover. If you enroll in “Medicare Advantage Plans,” also known as Part C, these plans are offered by private insurers.  They contract with Medicare and receive a per capita reimbursement from Medicare.  

• Since it is projected that health care costs for today’s retirees (excluding long-term care) can easily exceed $250,000, it is important to make informed and sometimes irreversible Medicare decisions by age 65, while monitoring changes and options in the future.

Where To Find Help Negotiating The Medicare Maze 

We cannot stress enough the importance of beginning to explore the enrollment process at age 64. It can also be helpful to seek professional guidance. We are fortunate to have Diane Markel in our office and she is quite knowledgeable about Medicare, but she would be the first to tell you she is not an authority on specific plans or policies. Three of our employees, Donna, Diane, and Alice, recently investigated Medicare options and greatly benefitted from the services of The Health Insurance Store, LLC provided by Bonnie Bloom. One office is located in Forest Hills, PA and their number is 412-349-8818. Aaron Zolbrod, the owner of The Health Insurance Store, LLC, has two other locations in Pennsylvania (Connellsville and Erie). Their website is www.getyourbestplan.com.

I had lunch with Bonnie and Aaron and was struck by their commitment to serving the needs of their clients. In addition, they do not help with other types of insurance, for example, home or auto—their focus is on healthcare. Aaron also shares a lot of high-quality educational information—something I am committed to as well.

We also can recommend Carol D’Alessandro, an insurance broker who handles our employee medical plans. She can be reached at 412-344-2500.

Please note: We have no affiliation with either of these businesses and offer these recommendations solely based on personal experience.

As always, if we can be of help, please contact us at 412-521-2732.