Medicare: It's Complicated

I am about to turn 65, which means I'm eligible to enroll in Medicare. But it appears that things between me and Mr. M are already off to a rocky start. Frankly, I think he's a lying cheating bastard who promises to love and care for you like nobody's business but then -- at least from what I keep hearing from friends who have already spent time in his company -- it turns out he's all talk and no action on claims, if you get my drift.

Plus, Mr. M acts as though he's never seen the likes of a woman like me -- you know, one who works for a large company that provides a health insurance plan, and who has no plans to retire at age 65. I would have thought that there were plenty of us -- refugees from the recession who need to hang on to our jobs for as long as we can.

But Mr. M keeps talking about being my primary guy. Frankly, I'm not ready to leave my company-sponsored plan and know that divorce can be costly. For those worried about their company dropping them, here's what our friends at the American Bar Assn. have to say: "Employers must cover older workers and their spouses under the same conditions as younger workers. Your benefits cannot be lowered just because you become eligible for Medicare. In fact, the employer insurance must remain the primary insurer. Medicare will cover you as a secondary insurer while you continue working."

No, actually the biggest worry I have about Mr. M is that he seems to have multiple personalities -- personalities that he likes to assign letters of the alphabet to. Medicare Part A is just for hospitals. Medicare Part B is for when you go to the doctors' office. I haven't figured out whether Part C is a game-changer, but I do know Part D is for prescription drugs.

Mr. M gives Part A to most people for free, probably just to show what a big spender he is. The other parts? Well they can get pretty expensive and you better believe that Mr. M is the kind of guy who says he left his wallet home when the check comes. And then there's that "I'm not totally emotionally available" thing he does: He's there for your checkup, but disappears when you need glasses, a hearing aid or dental care. What good is it when you can't count on his support for the real stuff, right?

Anyway, a hat tip to the National Council on Aging for attempting to school me on the complexities of this relationship. Here are some mistakes they caution against making:

Signing up too early or too late.
Open enrollment for Medicare is from Oct. 15 to Dec. 7. But if you are aging into Medicare -- meaning turning 65 like I am -- you need to start paying attention about three months before your birthday. offers a great calculator to determine which parts of Medicare you need. Vanessa Sink of NCOA cautions that those who are working for small companies need to check whether their company-supplied health insurance is as robust as Medicare requires. Those folks may need to get a supplemental plan.

Not understanding the difference between a Medicare Supplement and a Medicare Advantage policy.
Eyes are glazing over, right? OK, in brief: Most people supplement the government benefit with a private Medicare Supplement plan, also known as a Medigap policy. These Medigap plans cover some of the services that aren't covered by Medicare Part A and Part B.

A Medicare Advantage Plan is a Part C plan and it replaces Medicare A and B. These plans are sold through licensed insurance companies and often include prescription drug coverage and other things like vision care and wellness programs. The catch? They are the HMOs of the Medicare world. Subscribers have a limited choice of doctors and hospitals, but if they work for you, you can save some money.

Guessing when picking specific plans.
Yep, you won't be the first person to try to make sense of it all, only to give up and guess. NCOA strongly encourages you not to do that. The four key factors to consider seem to be: Do you have health insurance from another source (like a job); do you have any chronic conditions; which doctors and hospitals do you use; and which prescriptions do you need and where do you get them.

Before you start playing "eeny, meeny, miny, mo," hit up the Medicare Quick Check and see if it helps.

Not applying for extra help.
NCOA says that millions of older adults are eligible for billions of dollars in programs that can help them pay for insurance premiums, medications, deductibles and coinsurance. NCOA also offers a free online BenefitsCheckUp program to see if you are eligible.

Not re-assessing your coverage every year.
Given the complexity of it all, it's easy to understand why people slip into avoidance mode. But since insurance companies make changes to polices every year, it behooves you to re-evaluate your plan.

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