The Myth of Medicare

No, Medicare won’t take care of all your health care costs. Be prepared

By Barbara Pierce

Rae Raffle-Maxson, counselor at Catholic Charities of Herkimer County in Ilion: “There are so many options: we help find the best for you and help you enroll,” she says.

Don’t let the costs of healthcare costs ruin your retirement. Plan ahead.

Some say healthcare is the biggest retirement expense people fail to plan for. It’s a myth that Medicare takes care of all your health care costs.

“Most of your retirement savings may go toward your medical costs,” according to online.

“You might think your medical costs will be taken care of once you qualify for Medicare. But you’ll quickly find that you’re still paying out of pocket, and probably paying much more than you expected.”

Many folks assume Medicare will take care of your medical costs. Most people are overly optimistic about how much assistance Medicare will provide. In reality, it only covers about two-thirds of your costs. It has major limitations. You can’t rely on it alone to cover your medical care. And Medicare Parts B and D coverage get more expensive each year.

There are several reasons behind the mounting costs of medical care for retired people: In general, people are living longer, health care inflation continues to outpace the rate of general inflation, most retired people have an increasing number of unexpected health challenges as they age.

You can’t afford to go without a plan for how to pay for medical care as a senior. There’s a lot to learn about the world of Medicare. You’ll need to know about Medicare Parts A, B, and D, as well as Medicare Advantage and “Medigap” supplemental insurance plans.

Here are a brief summary of the basic things you need to know:

Medicare is health insurance for people 65 or older. You’re eligible to sign up for Medicare three months before you turn 65. It has three parts:

• Part A (hospital insurance): Helps cover inpatient care in a hospital, skilled nursing facility, hospice, and home health care. There is no charge for Part A.

• Part B (medical insurance): Helps cover services from health care providers, home health care, equipment, like walkers, wheelchairs. There is a monthly charge for Part B; it goes up every year.

• Part D (medication coverage): Helps cover the cost of prescription drugs (including recommended shots or vaccines). You join a Medicare drug plan in addition to original Medicare or a Medicare Advantage Plan. There is a monthly charge for Plan D and the pharmacy will charge for your medication.

There are two main ways you can get your Medicare coverage: Original Medicare or a Medicare Advantage plan.

Original Medicare includes Part A and Part B and you can join a separate Medicare drug plan to get medication coverage (Part D). You can use any doctor or hospital that accepts Medicare. There will be a gap between what Medicare pays and what the services cost, so you can also purchase a Medicare supplement plan from a private company to cover the gap.

A Medicare Advantage plan is a Medicare-approved plan from a private company that offers an alternative to Original Medicare. Your monthly premium will probably be lower. You will need to use health care professionals in the plan’s network. These plans offer benefits that Medicare doesn’t cover, like vision, hearing and dental.

Medicaid is a joint federal and state program that provides health coverage for those with limited income and resources.

As this is a complex process, much-needed help is available.

“We do really great things,” said Rae Raffle-Maxson, counselor at Catholic Charities of Herkimer County in Ilion.

Herkimer County Office for the Aging contracts with Catholic Charities to offer assistance in health care decisions.

“We help Medicare beneficiaries look at insurance options. There are so many options: we help find the best for you and help you enroll,” added Raffle-Maxson.

“For example, the income limits for a program that saves you on your Medicare premium just went up,” she said. “This means many more people are eligible and won’t have to pay the monthly premium for Part B. The monthly income limits are $2280 for an individual; $3077 for a couple. (Gross income, not net.)  This will help with some of the burden of paying for medical care. Also, the income limits for Medicaid also went up in 2023, so a lot more people will qualify for this assistance.”

“Another way we help is to connect people with EPIC (Elderly Pharmaceutical Insurance Coverage.),” she continued. “This helps people pay for prescriptions. The income limits are $75,000 for an individual; $100,000 for a couple.)

Every county in New York has a HIICAP (Health Insurance Information counseling and Assistance Program) such as Raffle-Maxson offers in Herkimer County. HIICAP Counselors offer free information, confidential counseling, and assistance to help solve medical coverage problems.

To schedule an appointment with Raffle-Maxson, call her at 315-894-9917.

In Oneida County, HIICAP counselor offer services at North Utica Senior Center and Cooper City Community Center in Rome. To schedule, call the Oneida County Office for Aging at 315-798-5456.