Tag Archives: Medigap

The ABCs (and Ds) of Medicare: Back to the Basics

Why do so few people in Medicare brochures wear glasses? (Sometimes the men do.) Why do so many of us aging Americans view 65 — the age at which we qualify for government-sponsored healthcare (thank you, LBJ) — as a natural end to our full-time working years? Who could have predicted that learning the ABCs would be a task not only for toddlers but for those of us toddling toward retirement, too?

“Don’t let the alphabet confuse you,” a BlueCross BlueShield Minnesota rep told me last January during the first of my phone calls to learn more about Medicare. Back then, I thought understanding the multi-pronged program would be child’s play.

“Parts A and B are original Medicare,” he explained patiently, while I pictured him holding up colored wooden blocks. “Part C is an advantage plan. Part D is prescription drugs.”

D is for drugs, I told myself: I can remember that!

The ABCs of old age

Turns out, there’s so much more. I have learned that the weightiest decisions about Medicare — whether to enroll in a Medigap or an Advantage plan, when to enroll in Parts B and D without facing a lifetime penalty, which private insurer to use — can all be delayed since I plan to keep working full time, with employer-provided healthcare, after I turn 65 in July.

Still, my months of research have changed my perception of where I am in life. Wrinkles flank my mouth and crease the bridge between my eyes. My right hip hurts from over-exercise. I feel the beginning twinges of arthritis in my hands. Or am I finally just acknowledging the obvious?

“I’m officially old,” I texted my lifelong friend, who turns 65 in May, six weeks ahead of me. “Just enrolled in Medicare Part A.” (That’s the part that covers most hospitalization expenses and is free at 65, provided you’ve worked long enough to qualify.)

“If I didn’t tell you today, I LOVE YOU!” she replied, reassuring me that I am really only “young-old.” Age reveals the importance of family and friends, the relationships we nurture because we need one another as we feel our way forward, toward the inevitable end time.

Marketing Madness

An unmarked white envelope fell out of my newspaper the other morning, an ad to join AARP. Did all subscribers get these, or is generational marketing that sophisticated? My mailbox hasn’t been so stuffed with ads —invitations to Medicare 101 classes, appeals from insurance companies whose chief executives earn multiple millions of dollars a year — since I aged out of the desirable demographic of 18 to 54 years old.

The first piece of Medicare mail has proven the most useful. A tall, laminated, two-sided flyer from UCare, it looks and functions like a large bookmark and has sat atop the growing pile of brochures for months. One side declares in oversized, old people–friendly type what steps to take six, four and three months before you turn 65; the other side urges you toward the research you should do anyway if you plan to keep working past age 65 and are fully insured.

Three key points that months of research has taught me:

First: Other than Part A (the standard hospitalization coverage), Medicare, contrary to assumptions, is not free. Nor is it the Bernie Sanders vision of a single-payer, government-sponsored program. A former colleague of mine retired nine months before turning 65. Despite careful budgeting and the blessing of her financial advisor to walk away from a six-figure salary before she qualified for Medicare, she said the monthly cost of post-retirement healthcare coverage surprised her: “It’s expensive!”

Second: If you have healthcare through your employer, and plan to keep working past 65, determine whether the prescription drug coverage is “creditable,” meaning it at least equals Medicare Part D; that’s the only way to delay Part D enrollment without a penalty once you have turned 65. (Given that a trusted neighbor contradicted the advice from a BlueCross salesman, I have fact-checked this several times.)

Third: “Original Medicare” — Parts A and B — covers only 80 percent of your expenses. That means you have to figure out the distinction between a Medigap supplemental plan and the relatively new (since 1997) Advantage plans, which are cheaper, more bound to a network of providers and recently have been in the news for denying claims. Heavily marketed, they appeal to healthy, young-old people like me because of their emphasis on fitness programs and coverage for fashionable eyewear.

We ego-driven Baby Boomers don’t feature ourselves ever sliding into decrepitude or suffering the indignities that a more expensive Medigap plan would cover.

Medicare’s Promise and Potential

Just as I started saving for retirement at age 27 and have counseled my grown sons to do the same, I have spent months now researching how Medicare works and what health coverage I may need heading into these years when the uncertainty of life has never looked more certain.

Key to keeping the fear at bay has been talking to people who have crossed the bridge:

  • My politically conservative confidant who favors UCare because he won’t buy health insurance from a for-profit company like United HealthCare.
  • My friend who thinks Advantage plans are overrated and overmarketed; she uses a more expensive Medigap supplemental plan because it serves her wherever she travels, including overseas.
  • My buddy who swears that the free services of a broker — who, of course, is getting compensated by insurance companies — bring clarity to the head-spinning confusion of Medicare options. He laughed at my insistence on doing my own research (“that’s so like you, Amy”).

For those of us who have earned enough and had the discipline to save throughout our working years, Medicare opens a door to the final active stage of life. However much I may mock the glossy brochures — color photos of women walking in the woods, a laughing couple out on bikes, a man lingering in a bookstore, two women talking over coffee — I have to concede that the calmer life they portray looks good.

Nothing in the stack of marketing materials tells me how to decide when to leave full-time employment. How I’ll fill my time or discover a new identity. How my husband and I will belt-tighten once a tidy sum of money no longer drops into our checking account every other Friday.

Most of us know that retirement requires a baseline of financial planning; but emotional and spiritual planning are just as important.

Connie Zweig, Ph.D.

What I do know — and what one of my older sisters predicted — is that my view of work is shifting, almost without bidding, as I edge closer to the time when healthcare coverage no longer ties me to a demanding full-time job. Allowing others to control my schedule, always carrying the worries with me, rarely getting a full night’s sleep: It’s all less appealing and less physically possible as I age.

“How we retire, and how we imagine retirement, may be more important than when we retire,” says Connie Zweig, Ph.D. in her 2021 book The Inner Work of Age: Shifting from Role to Soul. “All this emphasis on working and doing . . . stresses that purpose comes through productivity and doesn’t appear to include more service-oriented doing or more contemplative, spiritual development,” she writes.

Maybe the Medicare brochures with all their bicycles and coffee breaks are marketing more than overpriced health insurance, after all. Maybe it’s time to listen, to see the end of work-as-identity as a new beginning. As a time when I finally will be free.