Signing up for Medicare

It's Elder Me getting ready to
sign up for Medicare!

I'll be 65 in September, and that means it's time to deal with Medicare, the government health insurance program for the elderly here in the U.S.  And much as I cringe to think of myself as "elderly," I have to remember the alternative.

Anyhow, here's my "first dive into Medicare" report. This is just a record of my experiences, and NOT MEDICARE ADVICE!!

The government knows your birthday, your income, whether you've been naughty or nice, and the folks at Medicare will automatically send you your Medicare insurance card before your 65th birthday. Everyone has to be enrolled in Part A, and you are automatically enrolled in Parts A and B (which together make basic Medicare) without having to do anything. If you're dropping out of Part B because you have retirement health care coverage from an employer, union, or professional association, there's info on the card that tells you what to do.

Along with your card, you'll get a little booklet titled "Welcome to Medicare." This is a godsend. Do not throw it away. It will give you a good overview of costs, coverage, options, and where to get help on the medicare.gov site. It also has phone numbers if you prefer to talk to people. And it will tell you what your monthly premiums will be for the remainder of the year. For anyone who is retired, like me, these premiums are taken directly out of Social Security.

Like a growing number of older Americans, I have some modest savings, but no pension or retirement health care coverage. That means I have to figure out what medical coverage I'm going to need, how much it's going to cost me, and how I'm going to pay for it. The "Welcome to Medicare" booklet tells you where to find a navigator to help you with this process if you don't want to go it alone.

When you turn 64, my advice is to prepare yourself for the onslaught of telemarketing calls you will get from people who want to sell you Medicare supplemental coverage. As my birthday approaches, these calls have slacked off, but for most of the summer, I got an average of six calls a day from these people, and it was maddening. Fortunately, the telemarketers only had my landline number, and I have my cell phone set to reject calls from anyone not on my contacts list. You may need a strategy to deal with the incoming calls.

Whatever coverage you opt for now can be changed during Medicare's yearly Open Enrollment Period at the end of each year. So my plan is to sign up for the coverage I think I'll need at the outset,  and then rethink coverage as I go.

Part C Medicare plans roll Parts A and B plus some other benefits into managed care. These may be good plans and good deals, but they usually restrict you to a specific hospital system or physician's list. So you need to make sure that your current doctors, labs, and hospitals are covered before you sign up. If you are planning on moving outside the service area of the Part C plan you choose, that may leave you with no convenient care.

There are also Medigap or supplemental plans that simply reduce your Medicare out-of-pocket costs without confining you to a Part C managed care plan. I decided I was happy for now with Parts A and B.

Basic Medicare does not cover medication, and that's the biggest bite with the program. Fortunately, the medicare.gov will help you find and enroll in a Part D plan that will help with med costs. The site's Part D finder works like this:

1. You type in a bit of info and your ZIP code
2. You list all of your meds 
3. You list the pharmacy you usually use
4. The finder tells you what the full price of your meds are per year (write down this number!)
5. You are taken to a list of plans in your area

Once you have a list of Part D plans (and these are rated from 1-5 stars by users (just like the clothes you buy at LL Bean), you'll have to do some math. If, say, the full price of your meds is $600 per year, a premium over $50 per month would cost you more than just paying for your meds out of pocket. You also have to factor in any small co-pays or deductibles on various plans. In addition, the site will tell you if any of your meds are NOT covered on certain plans. (I take an albuterol inhaler for asthma that none of the plans I looked at covered.) It could also be cheaper to get your meds from a by-mail pharmacy, and the plan descriptions will tell you that.

If you find a Part D plan that works for you, you can sign up in just a few minutes.

Finally, it's worthwhile to fill out a Medicare authorization form that allows someone besides you to have access to your Medicare info. That person is probably a spouse, partner, close friend, sibling, or what not.

So: Bottom line, I feel pretty well covered. Medicare plus my Part D plan will cover about 80 percent of just about any medical care I anticipate needing in the next few years. And I am grateful I have lived long enough to be "elderly."

Be well!