Turning 65? Clear up confusion on Social Security, Medicare

Retirement used to be simpler. At age 65 you would generally start collecting Social Security and also begin to be insured under Medicare. It was the frequently accepted retirement date from your job and, with your gold watch and farewell party, everything was set.

Today Boomers might decide to begin collecting Social Security at 62 or wait to claim at age 70 or take the middle road and collect beginning at age 66 which is today’s full retirement age, a date that will creep up in the future.

The Medicare qualification date for those who have not been on Social Security Disability is still 65. Many Medicare qualifiers are still working today.

This can make things complicated. If you receive your health insurance through your employer or through your spouse’s employer and reach age 65, do you apply for Medicare or does your employer’s plan cover you? This information may help.

1. Basic things to know when turning age 65. If you are still employed and receive health insurance through work and you work for a larger employer, the chances are good that you continue being covered under your employer’s plan. Medicare Part A could be a secondary health insurer. If you do not know, check with HR. Then check again when you leave employment.

If you work for a smaller employer or you are self employed, Medicare would likely be your primary coverage. You need to check into signing up for Medicare A, Medicare B for out-patient doctors, medical supports and equipment, and Medicare D for prescription drugs or you might instead sign on to a Medicare Advantage plan.

2. If you need to sign up for Medicare because you do not have equivalent coverage through work and are turning age 65 you have a window of time during which you can make your choices. For people who are turn-

ing 65 and are retired or do not have the needed employer related health insurance, it is especially important to make timely choices on Medicare B and Medicare D because there are penalties for late enrollment.

3. Choices you initially make could lock you in later. On turning 65 or on initial eligibility, you might choose a Medicare Advantage Plan (an HMO, PPO, PFFS) or a Medicare

Supplement (Medigap) with Medicare or you could simply have basic Medicare. If you choose a Medicare Supplement when you are first eligible, you will not have to go through medical underwriting then or later. If you choose a Medicare Advantage Plan and later want a Medicare Supplement, you will likely have to undergo medical underwriting to change. This means, if you first chose a Medicare Advantage Plan because it is less expensive and your health deteriorates later, you may not be able to get a Medicare

Supplement later. So the safer choice, if you can afford it, might be to start with a Medicare Supplement. You can switch from a Medicare Supplement to a Medicare Advantage later without underwriting.

4. Open Enrollment is for Medicare Advantage Plans (HMO’s, PPO’s, etc.) and for Medicare D (Prescription Drugs). If you are already on Medicare and want to change your Medicare Advantage Plan or Prescription Drug Plan (PDP), then the open enrollment period to do this is basically from October

15 to December 7.

5. All Medicare Supplement (Medigap) Plans With the Same Letter Have the Same Coverage. Differences between companies are in the servicing and cost. If you buy a Medicare Supplement Plan from United Healthcare, for instance, and you compare it to a Medicare Supplement Plan from Humana, as long as it has the same letter (For instance, Medicare Supplement “G” or Medicare Supplement “N”), it has the same coverage. The differences are customer service and cost. If you want to know what

each coverage is by the letter, check out www.medicare.gov.

6. There is a wide diversity of coverage among Medicare Advantage (HMO, PPO, PFFS) plans. The differences among Medicare Advantage plans are complicated. It would usually be helpful to consult with an expert since most of the materials you receive by mail are likely to be for advertising purposes only.

If you are confused, get help. The Chester County APPRISE program (610344-6035) staffed by volunteers, is excellent or

check with an elder law attorney or insurance agent who works in this field.