There are more than a few myths about Medicare; when you should get it, how it should work, and what it covers. We meet many potential retirees and hear the myths repeated over and over. Google is not a great source for unbiased Medicare information. Medicare’s website is very comprehensive but understanding it can be challenging for those new to Medicare. Finding a trusted source for information particular to YOUR situation will be the most important task when you are nearing age 65 or past age 65 and planning to retire. Your trusted agent can provide you details that assist you in making a very important decision for your future, one that will help you retain health and money.
Qualifying for Medicare is determined by turning 65, Social Security disability pay of 24 months, End Stage Renal Disease or ALS diagnoses, or leaving creditable employer coverage. If working past 65 with creditable employer coverage, you can either elect Medicare, elect Medicare Part A, or delay Medicare Part A and B. The key to delay Medicare means your large employer coverage must be as good as Medicare’s Prescription coverage. An annual notice is provided to you from your group health administrator telling you whether your coverage is considered creditable or not. With legislative changes in the past two years, this may be more difficult for employers to maintain.
A myth that Medicare is free and covers almost everything when Medicare was never designed to cover everything is very common. Written in the 50’s and enacted into law in the 60’s there have not been many changes to that law. Medicare Supplements, Part D drug plans, and Medicare Advantage have all come about to fill the large gaps between Medicare coverage and the massive change to the cost of our medical care and prescription drugs.
The Inflation Reduction Act 2022 is helping consumers who have very high-cost medications by putting a cap on consumer spending. Yet until negotiations with Pharmaceutical companies are finalized and implemented there is a negative effect on the consumer as well. Right now, insurance companies are on the hook for the costs that Medicare is no longer paying as well as what consumers previously paid for prescriptions prior to IRA. This comes full circle back to the consumer with increased premiums for Part D plans both in 2024 and 2025.
For our agency, this means looking at how we can repackage insurance policies for our Medicare clients. Investigating creative ways to provide other coverages that Medicare ignores or in areas that individuals are more worried about; such as, dental, vision and hearing, or where you would like to recover after a stroke, heart attack, or cancer…at home, in a facility, or a combination of both? This is all part of the service we provide you for no additional cost, as your partner and trusted agency in Medicare Health Plan solutions.