Getting close to 65? Now's the time to understand the realities around Medicare for health care needs

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Updated Oct 30, 2022

For the first 40 years of my marriage, for the most part I let my wife make the decisions around, and appointments for, issues related to my health care. (I certainly didn’t make the call about the colonoscopy appointment myself!) Getting ready to turn 68, my life has changed, and I’m thankful that my wife, Marcia, a retired registered nurse, is now my go-to advocate and tutor on these matters. While she’s managed these decisions alone for so long, I’ve most definitely begun to realize how important it is for both of us to know what is going on with our health.

That includes our health insurance.

Managing health care and insurance, especially once you get to Medicare age, can feel overwhelmingly complicated. Yet I encourage you not to put off studying your options before you turn 65 and become eligible for Medicare. The options you choose will affect your care and cost. For instance, how many times have you been led to believe that a Medicare card was tantamount to a ticket to free health care? 

Well, it isn’t. Yet over the last few years I’ve had several younger owner-operators tell me how they look forward to free health care when they turn 65.

What follows is just the tip of the iceberg of information you might need to know about Medicare. My goal is to help drivers feel more confident in their knowledge about the benefits they are entitled to. Whether you are currently 65 or getting close to it, making decisions about Medicare and implementing those decisions should be a high priority for a successful future, whether you continue to drive or decide to retire. 

There are four types of Medicare. 

The first one, Part A, is what most people think of when they hear the word Medicare. It is true that you don’t have to pay premiums for Part A, as long as you have paid into Medicare with taxes for a minimum of 40 quarters (10 years). There are, however, co-pays, coinsurance (percentages of total costs you’re responsible for) and out-of-pocket deductibles to be met. For instance, in 2023, assuming you haven't paid any of the $1,600 2023 Part A deductible, a week of hospitalization will cost you that much out of pocket.

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Medicare Part A also covers a limited amount of skilled care in a nursing home, home health care and hospice care. 

Medicare Part B is also administered by the government and covers things like doctor visits, outpatient care, home health care, durable medical equipment and many preventive services. You must pay a premium for this coverage, which for most middle-class Americans will run $164.90/month in 2023. Those earning more than $97,000 of modified adjusted gross income (or $194,000 for a couple) will pay more. This premium is normally deducted from any Social Security payments you are receiving, or if you are waiting to take Social Security, Part B will bill you each month. 

Medicare Part D is administered by private insurance companies, and helps to cover the cost of prescription medications. The monthly premiums and coverage levels vary.

One of the most important things to know about all these parts of Medicare is that failure to sign up when you first become eligible can yield a penalty every month for the rest of your life. Most folks are eligible the three months before they turn 65, their birthday month and the three months after their birthday month. So be sure to go online during that time and sign up. If you or your spouse carries insurance through work, you should still sign up, though you normally won’t have to pay any Part B or D premiums or penalties if that care is covered under your private employer’s insurance.

Original Medicare pays for much, but not all, of the cost for covered services and supplies. Medicare Supplement Insurance (Medigap) policies sold by private companies for a premium can help pay some of the remaining health care costs for covered services and supplies -- copayments, those coinsurance responsibilities, and deductibles. It is a good way to reduce risk should you require a lot of medical care.  

One of the most popular ways to access Medicare Parts A, B and often Part D as well is through a Medicare Advantage plan, sometimes referred to as Part C or with the MA acronym. These plans are administered by a number of different private insurance companies who are paid by the government to administer your Medicare benefits. These plans are attractive to some because they may offer benefits not available if you are just relying on standard Medicare benefits. Some of those benefits: free gym membership, cash rewards for partaking of preventive services, dental and/or vision benefits, in-home meals for homebound enrollees, and free over-the-counter medications and items.  

However, MA plans may limit where you can access services or require more pre-authorizations than regular Medicare. The monthly premiums and out-of-pocket costs vary, and there are quite a few different plans to choose from.  

[Related: POLL: Owner-operators, what's your current health-insurance situation?]

The good news is that every year there is an open enrollment period from October 15 through December 7, when regular Medicare and Medicare Advantage enrollees can examine the changes for the following year and decide if they want to change plans or stay with what they have. Below, find some quick links that may well help you answer more questions.

Have a happy, healthy day, drivers!

Quick-link resources: How to sign up for Medicare, more

**Access basic videos about Medicare via this WebMD site.

**This fact sheet offers easy-to-understand further info about Medicare Parts A, B and D. 

Find more information about health planning and insurance selection, among a myriad other topics, in the Overdrive/ATBS-coproduced "Partners in Business" manual for new and established owner-operators, a comprehensive guide to running a small trucking business. Click here to download the newly updated 2022 edition of the Partners in Business manual free of charge. 

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