Long-term care Medicaid Medicare Your Coverage Options

7 questions you should answer before you turn 65

Written by Diane Archer

Everyone has lots of questions about their health and financial security as they age. Here are seven questions you should answer before you turn 65 with links to simple information to help you decide what to do:

1.     Do you need to sign up for Medicare?  Medicare provides health insurance for people 65 and over and people with disabilities, regardless of income.  Whether to enroll in Medicare depends on whether you have employer coverage and what kind you have. (If you have employer coverage through your job or your partner’s job, click here to learn more.) If you do need Medicare:

  • Enrollment in Medicare Part A, hospital insurance, and Part B, medical insurance, is generally automatic if you have signed up for Social Security. Part A is free if you or your spouse has paid into Medicare for at least 40 quarters. You pay the Part B premium unless you qualify for Medicaid. You need Medicare Part B if your employer coverage is no longer primary once you turn 65. (To avoid penalties for mistakenly turning down Part B, check with Social Security at 800-772-1213;  you can also contact your local area agency on aging at 800-677-1116.)
  • Understand your supplemental coverage options and how to choose among them. Medicare only covers about half of your health care costs. If you enroll in traditional Medicare (see below), you will want additional coverage, supplemental coverage, to fill gaps and limit your out-of-pocket costs. For an explanation of your options, click here.  If you enroll in a Medicare Advantage plan, you cannot buy insurance to cover your deductibles and copays and other out-of-pocket costs.

2.   Should you enroll in traditional Medicare or a Medicare Advantage plan? It depends on the kind of coverage that’s important to you and whether you want as much choice of doctors and hospitals as possible. It also depends on how much you are willing and able to pay to get the coverage you need. Most people choose traditional Medicare because of the enormous choice of doctors and hospitals it offers anywhere in the country. (Note: Some insurers are involuntarily enrolling people in their Medicare Advantage plans when they turn 65. Make sure you’re not involuntarily enrolled.)

3.    Should you sign up for a Medicare Part D prescription drug plan? In most cases, yes, if you need drug coverage. But, you should understand the limits to that coverage and when your drugs will be covered. Here are six tips for keeping your drug costs down.

4.     What about Medicaid? Medicaid can pick up many of your health care costs that Medicare does not cover, including your Medicare premium, if your income is low.  Whether you qualify for Medicaid might depend on where you live. You can have both Medicare and Medicaid. Here’s how they work together. And, here’s what you need to know about the ways Medicaid can help you.  Even if you don’t qualify for Medicaid, here are five programs that lower your costs if you have Medicare.

5.     When should you sign up for Social Security benefits (if you have not already done so) and what will your  Social Security benefits be when you retire?  You should understand the benefits and risks of claiming Social Security early.

6.     Are you prepared if you need long-term services and supports? Today, two in five people with Medicare needing these services do not receive them.

7.     Do you have a living will and medical power of attorney, Advance Directives? You should. Get help from Caring Connections.


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