MEDICARE
Continued from Page 17
whether to supplement with a Medicare Advantage Plan, aka Part
C, or go with a Medigap plan.

Under Part C, you may pay a smaller yearly deductible and a
small co-pay for doctor visits. But the cost of that annual premium
could skyrocket. That why you’re getting besieged with mail from
insurance companies touting that plan you’ve simply got to have.

The problem is that what might work best for your best friend
or your neighbor might not work best for you.

“The number of people who come to us because they made mis-
takes is depressing,” said Donna Omdahl of 65 Incorporated, a Mil-
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“We go through the process with each applicant, starting with where
they are now. And try to figure out what might work best
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“Through education, they’re able to decide.”
Much of that education can come straight from
the horse’s mouthpiece itself —medicare.gov —
which offers step-by-step instructions about how to
proceed when applying for Medicare.

It tells you what services are offered under each plan,
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mail all this information to you — assuming you can
find someone to help request it.

But, according to Omdahl, there’s a glitch in the
system (surprise!) that confuses people who don’t un-
derstand the difference between original Medicare and
a Medicare Advantage Plan.

They assume that once they choose one they’re covered, along
with a reliable prescription drug plan (Part D), across the board.

That’s not necessarily true.

While most Medicare Advantage Plans include some kind of drug
coverage, original Medicare requires signing up right away. Otherwise,
you may have to pay a penalty. Then you pick the plan you want,
with the monthly premium added to your Medicare premium.

Got all that?
“The thing is with the original Medicare, you have to pick two
of the options,” said Omdahl, whose company offers education sem-
inars to clarify the misconceptions. “But it isn’t clear on the website.

Consequently, people think they have to pick one of each.

“The basic idea is we need to have proper care as we get older.

Once you understand that and understand there are two distinct
parts to the decision of how to package it, things become clearer.”
When you go with a Medicare Advantage Plan, it supple-
ments the costs basic Medicare doesn’t cover. Of course,
there’s a hefty premium for that on top of the basic
Medicare fee. And there’s likely a deductible, too.

Medigap plans, on the other hand, have a con-
siderably lower premium and little or no de-
ductible. But if you wind up in the hospital for sur-
gery or some other condition that requires a stay and
various tests, your out-of-pocket costs can be prohibitive.

In essence, those on Medigap are betting on themselves that
they won’t have any major issues. While it’s nice to be optimistic
rather than thinking the sky is falling any minute, it may not be the
most pragmatic.

Logic suggests the older we get, the more likely our bodies are
to break down in some way. To deny that to save a few bucks up
front may not be the smartest move — especially if six months or
so later you’re paying big bucks because something went wrong.

But it’s your life.

And it’s up to you to decide how Medicare should work for you.

That’s assuming you’re not still under your working spouse’s health
care plan, which would limit you to Part A, because the rest is already
covered by insurance. In that case, the two of you need to figure out
the best way to proceed.

But don’t listen to just anyone. Listen to those who know your
situation and will help make the best choice for your particular
circumstance. “Many people tell us, ‘My neighbor said this,’ or ‘My brother-in-
law said that,’” explained Rutberg, who said the local APPRISE office
includes volunteers with legal backgrounds, as well as those in phar-
maceuticals and health care. “If you listen to them, you can choose
something much more costly as a result.

“But in many ways with Medicare and Medicaid and all the dif-
ferent drug plans, they couldn’t have made it more confusing.”
Hopefully, some of this will clear up the confusion.

If not, try to set up a meeting with a representative of APPRISE,
which often can take place in your local library or another public
venue. And if you think it’s worth it to spend the money up front to
ensure you won’t be spending a whole lot more money later for mak-
ing the wrong decisions, contact one of the fee-based companies.

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