Happy 65th

A working professional turned 65 and celebrated her birthday by being Medicare eligible. She was one of the reported 10,000 Americans to do so on any given day. She also still had employer coverage. Here’s her health insurance story:

How was her health? She was generally healthy, but had a recent respiratory condition and a successful joint replacement. She had good health habits, including regular exercise, good diet, and no smoking. 

What were her health care needs? She had a long-term relationship with a primary care physician, who managed her care. She obtained specialty care through a local health system’s provider network.

When did she start the process? She signed up three months before turning 65, as soon as allowed by Medicare. Everyone also has up to three months after turning 65 to do so.

What did she do? She signed up for Park A (hospital) because she didn’t have to pay a premium. She didn’t enroll in Part B (medical), which required a premium, because she had employer coverage.

When will she sign up for Part B? The month before she retires and loses her employer coverage. After a quick call with Social Security, she thought it best to enroll two months before “just to be safe.”

What about dental and vision coverage? She had supplemental coverage through her employer, which will end when she retired. Medicare does not provide either dental or vision coverage at this time.

What else? She worked with a health insurance broker to be sure that she understood the deadlines, her choices, and next steps correctly. She also spoke with Social Security’s help desk, which she found helpful.

Like any health insurance program, Medicare has lots of rules. While this consumer still enjoyed the benefits of—and rules for—her employer’s health plan, she had learned Medicare’s enrollment rules. In other words, she was Mastering Health Insurance.

Sources: KFF (2021 data)

Photo: The Bean (Cloud Gate) by Anish Kapoor