The Medicare enrollment period reopens on Oct. 15 and runs through Dec. 7, offering a 54-day window for adults older than 65 to enroll in or alter their Medicare coverage for 2022.
Experts warn that while many expenses decline in retirement, healthcare spending increases. According to Fidelity, the average couple age 65 in 2021 in the United States needed roughly $300,000 saved after tax just to cover their retirement health care expenses. Those with family histories of severe illnesses or those with preexisting conditions will need even more.
“In this atmosphere,” says Dave Rich, CEO of Ensurem, a Florida-based insurance technology and product distribution firm, “it is more important than ever that seniors be able to navigate the complex Medicare insurance market and find the plan that best fits their needs.”
Efforts are underway to save seniors money. President Joe Biden’s administration last month unveiled its promised initiative aimed at cutting drug prices, saying it will test new ways to reduce such costs for the Medicare health insurance program including tying payments for medications to their effectiveness. The U.S. Department of Health and Human Services (HHS), which oversees the federal medical insurance program for people aged 65 and older and the disabled, announced the initiative, which will use models to gauge the clinical value of medicines to determine how much Medicare pays for them.
The U.S. Census Bureau says that employment-based insurance covered 55.4 percent of the population in 2015, the most recent years for figures, followed by Medicaid (19.5 percent) and Medicare (16 percent). Residents of other countries may be covered by government standardized health programs. It pays to know the rules of each plan to avoid unnecessary expenses that can eat into retirement dollars. For those Americans who will be relying solely on Medicare, find a counselor who can spell out the intricacies of the plan, or use the free tool on Medicare.gov.
According to AARP, by the time a person reaches age 65, he or she has a 50-50 chance of needing long-term care at some point in the future. That requires advanced budgeting as well. Many people find that Medicare supplement plans can bridge the gap in expenses that government-run plans will not cover.
Medicaid pays for the largest share of long-term care services in the United States, according to the Administration on Aging. But to qualify, one’s income must be below a certain level and the person must meet minimum state eligibility requirements. Also, there may only be a handful facilities supported by the government, so applicants cannot be picky about accommodations.
Medicare does always cover most custodial care such as bathing, dressing, toileting, and eating. Custodial care is the primary form of care in nursing homes. Therefore, many people must find alternative ways to finance nursing home and other long-term care options. Those who must pay out-of-pocket spend an average of $85,000 per year on a nursing home in the U.S., and this is often an expense that has not been included in retirement budgets.
Financing long-term care is something individuals must consider as they make their plans for the future. It is a large expense that cannot go unaddressed even though the need for care might be in the distant future. And the application process can be complicated.
“It’s a maze,” Rich says. “To avoid getting unneeded coverage, to make sure they have the coverage they do need, and to keep their costs to a minimum, seniors need to do research, seek advice, and be prepared.”
-Combined wire services
Sign up for Long Island Press’ email newsletters here. Sign up for home delivery of Long Island Press here. Sign up for discounts by becoming a Long Island Press community partner here.