Even Fools Know Medicare Can Be a Problem

By Stephen J. Silverberg
New York Elder Law Attorney

Pre-retirement, many folks think they have only to enroll in Medicare and all will be well – including their health care budget. It would be great if it was that simple. It’s not. And not understanding how Medicare works and which plan to pick can make medical expenses a bigger part of a retirement budget than expected.

“79% of Future Retirees Are Dangerously Ill-Informed About Medicare,” reports The Motley Fool, and we think that’s on the low side.

Our office now includes a conversation about Medicare when people come for estate planning and elder law matters. We have found that many educated and informed people don’t know some basics about Medicare. Few understand the complex labyrinth of rules that can have a big impact on their monthly health care budget—and their overall health care costs.

Let’s start by setting one thing straight: Medicare Part B is NOT free. You have to pay for it.

Medicare A is divided into Parts. Many Parts.

Medicare Part A is free. It covers hospital care, but: there is a deductible: $1,364 if you land in the hospital before Medicare kicks in to cover the rest of your services. You may also be responsible for coinsurance, depending on how long you are in the hospital.

Medicare Part B is not free. It covers preventive care, like doctor visits and screening tests. There is a premium to be paid, and the current standard premium is $134.40. But if you are a high earner, your premiums will be higher. For example, a married couple with an income of $170,000 to $214,000 must pay $189.60 for Medicaid Part B.

These are 2019 numbers. The numbers only go up.

For prescription drug coverage, you’ll need Part D. Here’s where it gets tricky and most folks mess up. There are any number of plans, and make the decision about which plan to select based on what medications you take routinely. Co-pays will depend upon the plan.

Medicare does NOT cover dental care, vision exams and hearing services. If you don’t want to pay out of pocket for those expenses, you’ll want a Medicare Advantage plan. But be careful—Medicare Advantage is an alternative to traditional Medicare. Costs vary by plan.

And there’s something else: Medigap, also known as supplemental insurance. You’ll pay for Medigap, but it will pick up the costs for certain deductible, coinsurance and copay costs under Medicare. But it’s another bill to pay.

There’s a lot more. Visit www.medicare.gov, and expect to be a little overwhelmed. Or make an appointment with our office for a Medicare Review Appointment. Call 516-307-1236.

About the Author
Stephen J. Silverberg is nationally recognized as a leader in the areas of estate planning, estate administration, asset preservation planning, and elder law. He is a past president of the prestigious National Academy of Elder Law Attorneys (NAELA), and a founding member and past president of the New York State chapter of NAELA.