Get What's Yours for Medicare: Maximize Your Coverage, Minimize Your Costs by Philip Moeller
GET WHAT'S YOURS FOR MEDICARE is a fact-filled resource book especially designed for folks getting ready to enroll in Medicare. It's also great for those already IN Medicare, who are considered some changes in their plan.
Medicare is becoming a huge issue, and for good reason. The demographics are drastically changing:
"Between 2010 and 2050, the United States population ages 65 and older will nearly double, the population ages 80 and older will nearly triple, and the number of nonagenarians and centenarians will quadruple."
One of my favorite features of this book are the sidebar "No One Told Me" tips. These are important facts that are overlooked.
Some Good News, Some Bad News
Mr. Moeller cautions us that the rules can be confusing: "Is Medicare complicated and often opaque and impenetrable? You bet." And so, we need to be extra careful, because medical expenses can wipe us out: "Medical expenses are, sadly, a leading cause of personal bankruptcy." As we get older, we become more vulnerable to these bills: "The longer we live, the more likely we are to run up larger, not smaller, medical bills."
There are 3 big Medicare steps: (1) Sign up at the right time and avoid penalties; (2) Choose from one of two Medicare paths: Original Medicare (with or without Medigap supplemental insurance) and a Part D drug plan, or, Medicare Advantage; (3) Understand what Medicare covers.
A key theme of the book is the to "Choose the right mix of Medicare coverage." The author explains the rules of Medicare Advantage. For example,
"Medicare Advantage plans restrict coverage to those doctors, hospitals, and other caregivers who are in the plan’s provider network. Original Medicare, by contrast, insures covered medical services from any provider who accepts Medicare."
Oops.
Perhaps one bit of "good" news is that the insurance marketeers will be anxious to sell us insurance: "No one, it seems, is happier about our coming 65th birthdays than the private insurers who want to sell us policies. There is a big reason the insurance companies are after our business--they get big payouts--up to $10,000 from Uncle Sam for every new policy. In fact, "some plans can make money by selling policies that effectively pay people to buy them!"
The last few chapters of GET WHAT'S YOURS FOR MEDICARE are important, if not cheery chapters. Here, we get the sobering news about long-term care: "Medicare does not cover long-term stays in nursing homes, assisted living facilities, and other custodial care providers." Here is another fact that I admit scares me: There is a 70% chance that we will need long term care services at some point.
In the last chapter, the author encourages the reader to make plans for end of life care. Don't leave it to chance: "Leaving your future health care planning needs to some undefined and distant mañana is a bad idea on multiple fronts." Instead, form a "Team You" to discuss end of life care. You can also decide if you need to make legal documents so that your wishes will be followed.
Here's another important fact, related to hospice care. When receiving hospice care, Medicare normally will not pay for "curative" treatment. However, in 2016, Medicare started a trail program "to offer participants the chance to use hospice and continue receiving curative medical care."
Minor criticism: I was surprised that the author made just a passing reference to free gym membership programs provided by many Medicate supplement plans. For example, the "Silver Sneakers" gym program is a great benefit, which I have discovered most seniors don't know about.
All in all, I found GET WHAT'S YOURS FOR MEDICARE to be a well-written, informative guide to the Medicare maze. The author includes case studies to illustrate pitfalls that are easy to fall into. I learned a lot from reading this book--I bet you will too. There is a Glossary of terms, as well as an Appendix listing links to helpful resources.
