Understanding the Basics of Medicare
Open enrollment for Medicare is coming this fall and the time is now to start researching your options. Whether you have already enrolled in Medicare, or this enrollment period will be your first, understanding the basics of Medicare will help ensure the coverage you choose is right for your health and your wallet. Here are answers to some of the most frequently asked questions below:
What is Medicare and who is eligible?
Medicare is a national health insurance program for those over the age of 65 or those under 65 that have certain disabilities. Medicare was designed to help support these individuals’ retirement health care needs while containing some of the associated costs.
When and how do I enroll? When a person turns 65, they can participate in what is called the Initial Enrollment Period. The Initial Enrollment Period begins three months before the month you turn 65 and ends three months after your 65th birthday month. If your birthday is on the 1st of the month, your Initial Enrollment Period starts four months before your age-65 month and ends two months after it. The Initial Enrollment Period is
(Financial
the time when you can make your first Medicare selections.
Every year there is an Open Enrollment Period during which individuals can change their health care selections from the previous year. It’s worth reviewing your situation annually, particularly if any of your needs have changed. For most of those eligible, open enrollment begins on October 15 of each year and ends on December 71. Special timeframes may apply depending on your situation. Consider consulting a financial advisor for guidance so you can avoid late penalties upon signing up.
Do I sign up for Medicare if I work past age 65? If you are still working at 65 and have qualified health insurance coverage from your employer or your partner’s employer, you can delay enrollment in some parts of Medicare until your Special Enrollment Period. During your Initial Enrollment Period you are allowed to sign up for Part A of Medicare when you turn 65, but delay enrollment in the other parts of Medicare. This allows you to avoid Medicare late fees while remaining on your current coverage. When you or your spouse stop working and your insurance coverage from an employer ends, you are eligible to apply to the other parts of Medicare within the Special Enrollment Period. This period begins the month your employee
coverage ends and lasts for seven months after, totaling an eight-month period 2.
What is the difference between Traditional Medicare and Medicare Advantage? Typically, the first decision you will make during enrollment is whether you want to participate in Traditional Medicare or Medicare Advantage. The main differences between the two are who provides the plan and the type of coverage. Traditional Medicare is provided by the government whereas Medicare Advantage is provided by private health insurance companies. When seeking medical care, the doctors and hospitals that are covered by the two plans vary 3 With Traditional Medicare, you can go to any doctor or hospital system in the U.S. that accepts Medicare coverage. In contrast, with Medicare Advantage you can only see service providers who are in your plan’s network and area of service. Those with Medicare Advantage may experience fewer options for care when outside of their service area or if fewer doctors are within network 4. Consider how traveling and where you settle in retirement may impact the care you receive under each plan.
What are the main components of Medicare?
Traditional Medicare and Medicare Advantage are each divided into different components of coverage: Parts A-D. Part A and B are the foundational components of Medicare.
Part A is what provides an individual with in-patient hospital care and some post-hospital services. Part B provides coverage for outpatient physician consults, such as lab tests or flu shots. Part D is coverage for prescription drugs. Parts A, B, and D comprise Traditional Medicare. Any health care need not covered within these three parts can be addressed through Medigap policies, which are essentially add-ons to your government plan from a private insurance company.
So, what is Part C? Part C is Medicare Advantage. Medicare Advantage plans are provided by private insurance companies and offer Medicare Part A and Part B coverage along with additional benefits such as vision and dental. A way to think about the difference between the two overarching plan structures is that with Traditional Medicare you sign up for a-la-carte components and Medicare Advantage is a bundled package of parts 5.
Does my coverage carry over year to year? Once you select a Traditional Medicare or Medicare Advantage plan, your plan will carry over year to year. However, it is beneficial to review your coverage and costs during each Open Enrollment Period in case your needs or the plans have changed.
Selecting health care in retirement can be a delicate balancing act between how much you
spend on annual expenses and the coverage you receive. Whether you are enrolling in Medicare for the first time or are reviewing your existing plan, a financial advisor can help ensure your insurance plan makes the most sense for your financial goals and health needs.
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1 https://www.medicare.gov/basics/get-started-with-medicare/getmore-coverage/joining-a-plan
2 https://www.medicare.gov/basics/get-started-with-medicare/ medicare-basics/working-past-65
3 https://www.ameriprise.com/binaries/content/assets/ampcom/pdf/ understanding-medicare.pdf
4 https://www.medicare.gov/basics/get-started-with-medicare/ get-more-coverage/your-coverageoptions/compare-original-medicare-medicare-advantage
5 https://www.medicare.gov/basics/ get-started-with-medicare/medicare-basics/parts-of-medicare
Duane J Lusson, CFP, ChFC, CLU, MSFS,
Squeaky Seats
I stopped at McDonald’s for a cup of coffee. I sat on the end of the long bench seat, a continuous bench that runs along a wall with several individual tables in front of it.
A man standing in line waiting for his meal wore a T-shirt bearing the famous green and blue Seattle Seahawks logo. But his bird wore a sombrero, and the caption read “Si-Hawks.”
Finding it quite humorous, I commented on the shirt. I told him I was a die-hard Broncos fan, then asked, “Why is it that when the Seahawks were in our division, you couldn’t beat us, but you switched to the NFC, and in the Super Bowl, you gave us one of the worst whippings in NFL history?” He smiled, answering, “It’s the sombrero.”
We shared a good laugh, and I returned my focus to my iPad.
The man and a woman came and sat two tables down. She sat on the vinyl-
upholstered bench seat, and he sat in the hard chair on the other side. The wife asked her husband, “Would you rather sit on this side?”
He answered, “No, I’m fine over here.” As he slid his chair toward the table, it made a loud noise that rubber pads will make on a hard tile floor, and then he said, “Boy, this chair is loud.”
I leaned over, tapped the lady on the shoulder, and said, “I don’t think it was the chair!”
We shared a good laugh about that.
“Now you know what I live with,” she said, shaking her head.
The husband said, “You’re on to me, buddy.” We shared another good laugh.
Several minutes later, the lady adjusted her sitting position. A loud, rumbling, squeaking noise was heard—the kind that happens when one is wearing shorts and sitting on a smooth vinyl surface. I looked in their direction. The husband looked at me, and his chest began heaving up and down as he chuckled, “Apparently she ate the same thing I did.” He and I shared a good laugh; she did not join in.
Her cheeks flushed redder than Ronald McDonald’s shoes as she defended herself,
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“That wasn’t me! It was the seat.”
“Of course it was the seat,” he said, still laughing and bouncing. “Your seat!”
She reaffirmed, “It was not me!” He and I continued to laugh.
I had to ask the lady, “Why was it funny when his seat made a noise—but not when it was yours?”
She answered very matter-of-factly, sitting up straight, holding her chin in a position of authority and knowledge. “Because men do that sort of thing, whereas ladies do not.”
The man snickered and spoke what I thought might be his last words: “Trust me,” then, quoting a country music song, he declared, “She’s no lady: she’s my wife.”
“Oh, my dear man,” I exclaimed with concern, “I had your back up until that comment, but now you’re on your own!” I picked up my tray to shield myself, prepared to deflect any flying objects and projectiles.”
His wife laughed and said, “It’s okay. I love that song.” Then asked, “Do you know Lyle Lovett?”
I answered enthusiastically, “Know him? We had dinner together just last night.” We shared another good laugh.
They went on to talk about their favorite songs and decide who was the best singer ever. She really likes Lyle; her husband preferred Cash. I had to side with her husband. Although I like
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some of Lyle Lovett’s music, he’s no match for Johnny Cash. (And Lyle needs to do something with that hair!)
When they got up to leave, the wife said to me, “Thanks for the laughs! I’m going to use that line about the chair!” He just shook his head.
I cautioned her, “Be careful using it—turn about is fair play, you know!”
The man agreed with me, “Darn tootin’ it is!” Then nudged my shoulder, “Get it? Tootin’?” We shared another good laugh, then offered each other salutations for a
good day!
I needed to get moving; I had a long way to drive. Instead, I got a refill of coffee. As I sat back at my table, the vinyl bench squeaked loudly. It was the kind of noise that would happen when you slide on shiny vinyl while wearing shorts.
A family sitting at a table across the aisle turned and looked at me with alarm; the mom seemed offended. “It was the bench,” I explained. The little boy and girl started to giggle; the dad just looked the other way. I don’t think they believed me.
Fishing Tournament
Everything is competitive. Even things that are meant to be relaxing, such as fishing, can be made a competitive sport. On Friday night, our grandson, Zane, decided we needed to have a fishing tournament. He and our friend, Pat, would be on one team and his dad and I would be on the other. There were to be two categories; most fish caught and smallest fish. I felt fairly confident as both Damon and I are very proficient fishermen. I have the added advantage of usually catching a fish or two that is too small to eat unless a person is going for sardines.
Damon and I discussed our starting time, deciding on fishing early before it got hot. Saturday was supposed to be clear, sunny, hot and humid. When Damon showed up at my place on Saturday morning, Zane was still in bed asleep, and nobody had heard from Pat. We had a quick cup of coffee and headed for the lake. Damon tried a few casts from shore but cleaning off his hook after dragging it through the six-footwide weed bed that ringed the lake took more time than casting and retrieving. We
THURSDAY
12:00
5:30-7:30
6:15
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FRIDAY
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6:00 – 10:00
KIDS & ADULT GAMES 2:00 pm PEDAL TRACTOR PULL 5:00 – 9:00 LANDSHARK ARCADE GAMES
FRIDAY & SATURDAY NIGHTS Bands on Stage 8:00 pm Door Prize Drawings 9:15pm Bands Resume 10:00 pm More info and updates: DCOSSR.org Facebook: @DavisCountyOSSR Reunion Booklet
jumped in the boat and headed out. Casting back toward shore worked much better. Fish were hiding in the weed bed and would come out into clear water to strike. Every few minutes, Damon would pull in a bass on his spinner bait. I was working with Mister Twister type plastic
grubs. Working them near the surface was not getting any bites. I tried diving them deeper and was only able to snag onto the weeds that were growing from the bottom in the deeper water. I could see all the way to the bottom and could watch fish chase my lure, they just would not bite it. Evey few minutes, I changed lures hoping to eventually run across something that would make them strike. I tried everything in the tackle box, even my wife’s favorite gray floating mouse. I ended up with one bluegill for the day when we finally came back to shore. Damon caught ten bass and one crappie. One little bass was about the same size as the lure he was using. It must have been very hungry to try to eat something as big as it was. I felt fairly confident in our
results, though I did not contribute much to the team effort. Eleven fish was not a bad haul, and it would be difficult to catch a smaller fish than the little bass. We had had about as much fun as we could stand and were back on the porch when the other team finally showed up. It turned out that Pat had to work until about four AM, about the same time Zane had gotten in from training a coon hunting dog. They were slow to motivate but finally headed out for their competitive round. Damon and I sat on the porch drinking coffee in the shade while Zane and Pat were out in the direct sunlight in the boat as the day
grew warmer. They worked at it for longer than I would have but did have some luck. Between the two of them, they caught forty fish, mostly bass. When they got back to the house, they were still not too energetic but did have the satisfaction of claiming the prize for most fish which consisted of a “congratulations”. We are not big on trophies. Even though Damon’s fish won the smallest award, I do not think he is going to have it mounted. Damon and I were ready to get on with doing something constructive for the rest of the day. I think the other team was going home and going back to bed..
