Newly Retired Couple in Colorado

A newly retired coupled was excited to leave the city for the mountains. They had employer-sponsored insurance for many years like more than half of all Coloradans. The couple shared their coverage story in retirement.

When the husband turned 65, he enrolled in Medicare Part A (as required) and kept his wife’s plan until she retired at 65. Then, they both enrolled in Traditional Medicare and bought supplement and drug plans. They each spent several hundred dollars in monthly premium.

The couple evaluated their options again during Medicare’s open enrollment season. He had just had his annual physical, and his nurse practitioner declared him as “so healthy.” Given the monthly-cost savings, he and his wife decided to switch to a Medicare Advantage plan.  

The couple’s new premium was $0. The plan had an annual out-of-pocket maximum of $6,300 per person. They could afford $12,600 annually as a couple if necessary. The plan included dental, vision, and hearing coverage, as well as a national provider network for when they travelled.

And then it happened. The husband was diagnosed with cancer, which required surgery and chemotherapy. He also had to go to Denver, where an academic medical center had “the best” oncologist for his care. He had spent $2,400 to date on out-of-pocket costs for treatment.  

The couple knew that they could switch back to Traditional Medicare during open enrollment. They also knew that “it would be very expensive to do so” because any Medigap plan could charge him more (or reject him) because of his pre-existing conditions.

For now, the couple was happy with their coverage. “In terms of health care, this Medicare thing is pretty good.” In other words, they were Mastering Health Insurance. #CancerSucks

Source: KFF (2022)

Photo: Colorado in winter