MetroWest CARES, the Committee Addressing Resources for Seniors, is coordinated by United Jewish Communities, and brings together leaders from MetroWest agencies to promote independence and support vitality among older adults. Each month, a MetroWest CARES agency has an opportunity to address a critical eldercare issue. This month’s column on Baby Boomers enrolling in Medicare is presented by JVS.
If you remember these events, experiences, inventions, and personalities, you are probably a Baby Boomer:
The Vietnam War: waiting for your lottery number; political protests; marching on Washington; the tragedy at Kent State; collective mourning after the assassinations of John F. Kennedy, Robert Kennedy, and Dr. Martin Luther King, Jr. The space race: the launch of Sputnik, watching Neil Armstrong walk on the moon. Media innovations: transistor radios, your first color TV. Rock ’n’ roll: the Beatles, the Beach Boys, Elvis. Television viewing: Dinah Shore, Lassie, Davy Crocket and his coonskin hat, Howdy Doody. Sports legends: the Brooklyn Dodgers, Cassius Clay.
If any of the above evoke some vivid memories, you were probably born during the Truman or Eisenhower administration and have either celebrated your 65th birthday or soon will. With that milestone, whether you’re ready to believe it or not, you officially become eligible for Medicare.
Do you know how and when to register for Medicare benefits, if you have not done so already? Will being a Medicare recipient mean you’ll no longer have to pay health insurance premiums? Will you need supplemental health insurance to cover what Medicare does not? Will you choose a lower cost-Medicare managed care plan, or are you more comfortable with a traditional plan? Now is the time to learn about what Medicare can mean to you. Unfortunately, it can take a while to educate yourself about what this important program covers — and what it doesn’t.
How do you make an informed decision on what will work best for you?
Below are some suggestions to get you started:
• Know your “Parts”
Medicare Part A covers the costs of a hospital stay, skilled nursing facility, home health care, hospice care, and medicines administered to inpatients. You are eligible even if you continue to be covered by your employer’s insurance as long as you have registered for Medicare and paid Medicare taxes for more than a decade (or are married to someone who has). There is no charge for this coverage.
Medicare Part B pays for outpatient hospital care, doctors’ services including preventive care, and some kinds of home health care — most medical expenses not paid for by Part A, except prescription drugs. There is a monthly charge for Part B coverage. Most people sign up for Medicare Part B either when they turn 65 or when they stop working, whichever comes later. It is important that you check the rules; if you don’t enroll in Part B when you should, you could be subject to much higher permanent premiums.
Medicare Part D helps pay the cost of prescription drugs that you use at home, plus insulin supplies and some vaccines. Part D plans are delivered through private plans, for which you pay a monthly premium. You are not required to enroll in Part D, but as with Part B, you will pay a permanent premium penalty for late enrollment. The covered medications and fees for these plans vary and should be researched before enrolling.
Medicare Advantage Plans are private managed care plans you can choose in place of the original, government-run Medicare program. They cover the benefits described above for Part A and B, and usually Part D. Medicare Advantage Plans typically require you to receive health care within a network of approved providers. Premiums tend to be lower than those paid by recipients who are enrolled in Part B, Part D, and a supplemental Medigap policy.
Medigap Plans are private plans that cover the co-pays and deductibles associated with Parts B and D; this coverage is generally not needed if you have a Medicare Advantage Plan.
• Don’t expect to be notified when it’s time to sign up: You must apply for Medicare. You won’t get an official notice unless you are already collecting Social Security.
• Do enroll three months before you turn 65: That way you are sure your coverage will start at the beginning of your birthday month. Sign up for Medicare Part A even if you are working and have health benefits. Waiting can significantly delay the date on which your coverage begins.
• Remember that Medicare is not free: Although hospital coverage (Part A) is free, you will pay premiums for coverage and copayments for most other services, and for prescription drugs, unless you qualify for a low-income program or have other, extra insurance. You may want to invest in a private Medigap policy to help cover these expenses.
• Give yourself time to learn about Medicare: It’s a system with many choices and deadlines. Being informed is the best way to avoid mistakes that cost money. Some suggested resources include the U.S. Department of Health and Human Services (Medicare.gov), AARP (AARP.org/health/medicare-insurance), Consumer Reports (Consumerreports.org/health/home.htm), or the Medicare Rights Center (Medicarerights.org/medicare-answers).
Learn more about the medical, financial and other issues facing baby boomers at the Fifth Annual JVS Creative Maturity Expo. This year the Expo will be on Sunday, Nov. 6, from 10 a.m. to 4 p.m. at the Leon and Toby Cooperman JCC, West Orange. For more information and the schedule please visit JVSNJ.org and click on the “Creative Maturity Expo” link.
Families and caregivers needing answers to broader eldercare questions and help with community resources can contact Elderlink — a portal to all MetroWest services for older adults and their families — at 973-765-9050 or firstname.lastname@example.org. Elderlink is on the Web at Elderlinkmetrowest.org.