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    Working past 65? Here’s what to know about Medicare

    If you plan to work past 65 and keep the health insurance you’ve had from your job, you’re likely to wonder what, if anything, you need to do about enrolling in Medicare.

    About one in six older Americans now remains in the workforce beyond what was once the traditional retirement age. And the number of older workers will only grow over time.

    One reason is that Social Security now requires you to be at least 66 to collect your full retirement benefits. Retiring earlier means a smaller Social Security check.

    Then, too, a number of sixty-something workers continue to pursue their careers because they can’t afford to retire. Still others simply prefer to stay engaged and on the job.

    Whatever the reason for postponing your retirement, you still need to consider Medicare as you approach your 65th birthday and qualify for the health care coverage.

    First, you should visit with your company’s human resources manager to determine how your employer-provided insurance will fit with Medicare. That’s also true for anyone turning 65 and receiving health care through a working spouse’s group plan.

    Most workers will want to sign up for Medicare’s Part A, which usually has no monthly premium and covers hospital stays, skilled nursing, home health services and hospice care.

    Of course, like most rules of thumb, there’s always an exception. And this one is no different.

    If your employer coverage takes the form of a high-deductible insurance plan with a health savings account, you should defer enrolling in Part A. That’s because the Internal Revenue Service forbids you to continue contributing to your tax-advantaged savings account once you have Medicare.

    When you sign up for Medicare’s Part B, which covers doctor appointments and other outpatient services, mostly depends on how large your employer is.

    If your company or your working spouse’s company has 20 or more employees, your employer-provided insurance will remain your primary coverage and will pay your bills first. You can delay enrolling in Part B until you stop working.

    If you or your spouse’s company has fewer than 20 workers, Medicare will become your primary coverage, and your employer coverage will be secondary, so you should sign up for Part B.

    Assuming that you’re not yet receiving Social Security benefits, you’ll need to enroll in Medicare by contacting Social Security at 800-772-1213 orwww.socialsecurity.gov.

    Completing the online application is fairly simple and typically takes 10 to 30 minutes.

    You should do this during what’s called your “initial enrollment period,” which runs from three months before the month you turn 65 to three months after your birthday month. For example, if your 65th birthday is in September, you can sign up any time from June 1 until Dec. 31.

    There’s also the question of whether you’ll need to enroll in Medicare’s prescription drug coverage, also known as Part D, when you turn 65 or whether you can put off that decision.

    Again, you should consult with your company’s benefits manager. If your employer plan includes drug coverage that’s at least comparable to Part D coverage, you won’t need to sign up right away.

    When you do finally stop working, you’ll be able to enroll in Medicare (Parts A or B) without risking a late penalty during a special eight-month enrollment period.  You’ll also have two months to select a Medicare drug plan without a penalty.

    To learn more about how your employer health plan works with Medicare, visitwww.medicare.gov/publications and view the booklet “Medicare and Other Health Benefits: Your Guide to Who Pays First.” Or call 800-633-4227 to request a free copy.

    Understanding how your insurance choices fit together as you continue working beyond 65 will help you get the best care for your dollars.

    By Bob Moos
    Southwest public affairs officer
    U.S. Centers for Medicare and Medicaid Services
     

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    Make the most of Medicare’s drug coverage

    Medicare offers prescription drug coverage to everyone with Medicare.

    It’s a good deal. Medicare subsidizes the outpatient drug benefit, generally paying about 75 percent of the program’s costs. Unless you already have comparable drug coverage through another source, you should consider getting it when you sign up for Medicare’s health care coverage at 65.

    There are two ways to get drug coverage. If you’re in Medicare’s traditional fee-for-service program, you can purchase a “stand-alone” drug plan from an insurance company. Or, if you decide to buy a private Medicare Advantage health plan, you can choose one that includes drug coverage.

    To find the “stand-alone” drug plans and the Medicare Advantage health plans with drug coverage available in your area, visit Medicare’s “plan finder” at www.medicare.gov/find-a-plan. You can also call Louisiana’s Senior Health Insurance Information Program for help at 1-800-259-5300.

    You’ll see there are significant differences in premiums and deductibles, in the co-payments the plans charge, in the particular drugs they cover and in the pharmacies they use. That’s why it’s important to look at your prescriptions and individual circumstances when comparing plans.

    Ask yourself: Which plans cover the drugs I take? Which plan gives me the best overall price on all my drugs? Which plans allow me to use the pharmacy I want? Which plans let me get drugs through the mail? What are the plans’ quality ratings, such as for customer service?

    You’ll discover that many plans place drugs into different “tiers.” The higher the tier, the greater your share of the cost will usually be. If you find that a prescription of yours is in a higher tier, you may want to ask your doctor whether there’s a drug in a lower tier that would work as well.

    You may also encounter plans that follow “step therapy.” That means you must first try a less-expensive drug that’s been proven effective for most people with your condition before you can move up to a costlier drug. However, your doctor can request an exception if the costlier drug is medically necessary.

    Medicare drug coverage is just like other kinds of insurance – you buy it to protect yourself if and when you need it. Even if you’re not on any prescriptions now, enrolling in a drug plan with a low premium guarantees you’ll have coverage should your health decline and you require medication.

    After you pick a plan that meets your needs, call the company offering it and ask how to join. You may be able to join online, by phone or by paper application. Don’t be alarmed when you’re asked to provide the number on your Medicare card during the enrollment process. In this case, it’s OK.

    The plan that’s best for you this year may not be the best next year. If so, you can switch to another plan between Oct. 15 and Dec. 7 each year. Indeed, it’s smart to check all your options every fall to make sure you have the plan that best fits your needs and pocketbook. Your new coverage then begins on Jan. 1.

    If you’re having difficulty affording medications, you may qualify for the government’s “extra help” program. Your annual income can’t be more than $18,090 if you’re single or $24,360 if you’re married. Also, your resources can’t exceed $13,820 if you’re single or $27,600 if you’re married.

    Generally, you’ll pay no more than $3.30 for each generic drug and $8.25 for each brand-name prescription in 2017. Forty-one percent of Louisiana residents with a Medicare drug plan get extra help. To apply, visit the Social Security website, at www.socialsecurity.gov/i1020, or call Social Security at 1-800-772-1213.

    People with Medicare have saved hundreds or even thousands of dollars each year thanks to their drug coverage. Be sure to make the most of yours.

    By Bob Moos
    Southwest public affairs officer
    U.S. Centers for Medicare and Medicaid Services

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    Many of Medicare’s screenings come at no cost

    How often have you tried to ignore an ache or pain by telling yourself, “Maybe if I do nothing, it’ll go away.” Sometimes, that works. But wishful thinking isn’t the best way to take care of yourself.

    Medicare has put a new emphasis on preventive health care.

    A few years ago, Medicare mostly concerned itself with paying for your treatment after you got sick. Now, it’s also focused on helping you stay healthy and avoid diseases and illnesses in the first place.

    People with Medicare are entitled to a broad range of exams, lab tests and screenings to detect health problems early, when they’re most treatable or curable. Many now come at no out-of-pocket cost.

    Many immunizations are also free.

    To make sure you get started on the right foot, Medicare covers a “welcome to Medicare” visit with your physician during the first 12 months you’re enrolled in the Part B medical insurance program.

    Your doctor will evaluate your health, discuss any preventive services you may need, like shots or screenings, and make referrals for more care if required. There’s no out-of-pocket cost.

    You can make the most of your visit by coming prepared. That means bringing a complete list of your prescriptions, your family health history and your medical records, including immunizations.

    Medicare also pays for an annual wellness visit with your primary care doctor. This isn’t the same as an annual physical, since it isn’t a head-to-toe examination. But it does provide the same opportunity to discuss your health.

    Your doctor will develop a personalized prevention plan to keep you healthy. The visit also includes a review of your medications and routine measurements, like your height, weight, blood pressure and body mass index.

    More than 40 million older Americans with Medicare – including 573,000 Louisiana residents — received at least one preventive service at no cost to them last year.

    Here’s a rundown of some of these services:

    • Cardiovascular screenings check cholesterol and other blood fat levels. Medicare pays for the test once every five years.
    • Blood sugar screenings can determine whether you have diabetes. Based on your health, you may be eligible for up to two screenings each year.
    • Mammograms check for breast cancer. Medicare covers a screening every 12 months for women 40 and older and one baseline mammogram for women 35 to 39.
    • Medicare typically pays for a flu shot once every flu season, a pneumonia vaccination and, if you’re at medium to high risk, a hepatitis B shot.
    • Colonoscopies can find precancerous growths early. Medicare covers the screenings once every 10 years or, if you’re at high risk, once every two years. You pay nothing for the test itself. If your physician removes a polyp, you may need to pay 20 percent of the Medicare-approved amount for the doctor’s services and a copayment for the outpatient setting.
    • Prostate cancer screenings include a yearly PSA test and digital rectal exam for men 50 and older. The PSA test is free. You pay 20 percent of the cost for the rectal exam, after meeting your deductible.
    • Medicare pays for one depression screening per year. The screening must be done in a primary-care setting, like a doctor’s office, that can provide follow-up treatment and referrals.
    • If you’re a smoker, you qualify for eight free counseling sessions each year to help you quit.
    • Likewise, if you’re obese with a body mass index of 30 or higher, you may be eligible for free counseling sessions to help you lose weight.
    • Medicare pays for HIV screening for people at increased risk for the virus, people who ask for the test, or pregnant women. Medicare covers the test once every year or up to three times during a pregnancy.

    Keeping up-to-date with screenings and immunizations is important, so Medicare encourages you to visit mymedicare.gov and register. There, you can see a description of your covered preventive services, the last date you had a particular test and the next date you qualify for it again.

    By eliminating the out-of-pocket costs for many screenings and tests, Medicare’s new emphasis on prevention not only can save you money, it can help you take control of your health.

    It may even help save your life.

    By Bob Moos
    Guest Columnist

     

    Bob Moos is the southwest public affairs officer for the Centers for Medicare & Medicaid Services. ONLINE:cms.hhs.gov. Medicare Buttons by http://www.hirejon.com/medicare/ 

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