Welcome everyone to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health.
The underlying theme of all my podcasts is in some way, shape, or form centered around longevity – how to live well for a long time. This week I had Medicare Independent Broker, Renee Thompson, on the podcast to talk about how Medicare is trying to keep pace.
Americans are living longer than they did in 1965, when Medicare was first established. Back then the average U.S. life expectancy was about 70. Today it’s about 77 ½ . According to the Social Security Administration life expectancy calculator, women celebrating their 65th birthdays today can expect to live to about age 86, and men to 84. That means Boomers will need Medicare benefits for an extra 20 years!
That’s why this podcast is important! Medicare plans change every year and if you are on the longevity train like me, you want to be assured that your health and wellness needs are going to be met. The podcast notes below are just an overview of my conversation with Renee. I hope you will take the time to listen to the full episode.
PODCAST NOTES
The Basics
Part A, Part B, and Part D are the fundamental components of Medicare. Part A provides hospital coverage, Part B covers medical expenses, and Part D offers drug coverage.
Part C, also known as an Advantage Plan, integrates hospital, medical, and drug coverage, often including additional perks like gym memberships (sometimes, not always) and vision, dental, and hearing coverage.
It’s crucial for those nearing 65 and getting ready to retire (or already retired) to enroll in Medicare and drug coverage to avoid penalties. Individuals who are still actively employed with creditable coverage are exempt from penalties for not enrolling at 65.
After signing up for Part A and Part B, you want to sit down with someone who can help you navigate your own personal health issues and whether you want to go down the supplemental road or the advantage plan road.
Plan Options
Advantage plans can come in the form of HMOs or PPOs, each carrying distinct network and coverage characteristics. An HMO (Health Maintenance Organization) plan means you need to stay in a network of doctors that accept this plan or you will typically pay out of pocket. A PPO (Preferred Partner Organization) plan has out of network coverage.
I have Plan G, which is a supplemental plan that offers universal acceptance (as long as they take original Medicare) and is beneficial for individuals who may travel frequently and want comprehensive coverage. This is the Medigap plan that covers the most. You don’t have to worry about networks with a supplemental plan.
Zero premium plans may be appealing, but it’s important to understand potential out of pocket expenses and coverage gaps, such as the “donut hole”. The “donut hole” refers to a coverage gap where individuals are responsible for a percentage of the retail cost of medications until they reach catastrophic coverage.
If you pay IRMA Part B, you’ll also pay IRMA Part D. To Learn more about IRMA and what it is for 2024, this is a great resource.
There are so many things to consider when navigating Medicare. Everyone’s situation is unique! As you or a loved one approaches Medicare eligibility, educate yourself on plan options, coverage details, and potential costs. For peace of mind, I encourage everyone to seek a qualified Medicare Independent Broker, such as Renee Thompson, to help guide you in making the best decisions.
Stay educated. Stay healthy.
Till next week.
