Insights from The Orlando Senior Help Desk: What you need to know before turning 65

Most people pay into Medicare through their payroll for their employment years, thinking that once they turn 65, the coverage will be free. Medicare has several expenses. High-income earners pay more in terms of copays, deductibles, and premiums.

Eye Examination and Optician-Original Medicare covers ophthalmologic costs like cataract surgery, but doesn’t cover contact lenses and glasses or routine eye checkups. Some people may opt to purchase a vision insurance policy, which costs several hundred dollars annually.

Hearing Aids-Medicare covers any ear-related condition but not hearing aids or routine checkups. Some Advantage plans do pay for hearing aids.

Dental Work-Both the Original Medicare and Medigap plans don’t cover dental procedures like root canals, dentures, or routine checkups. Some Medicare Advantage plans offer dental coverage. One can purchase a dental discount policy or an individual insurance plan for dental care.

Overseas Care-A majority of Medicare Advantage plans in the United States and the Original Medicare don’t cover any medical costs incurred outside the country. Several Medigap plans offer coverage for healthcare costs outside the U.S. Travel insurance policies may provide coverage overseas. You may also consider medevac (medical evacuation) insurance.

Podiatry-Medicare doesn’t cover routine foot care like the removal of callus. Medicare Part B covers foot examinations and treatment provided it relates to nerve damage resulting from diabetes. It also covers care for foot ailments and injuries like heel spurs and hammertoe.

Cosmetic Surgery-Medicare doesn’t cover elective cosmetic surgery.

Nursing Home Care-Medicare covers limited rehab facility treatments (usually 3or 60 days). if you’ve undergone a hip replacement and thus require inpatient physiotherapy, your coverage will take care of the expenses. If the condition worsens and needs to be transferred to a nursing home or an assisted living facility, the policy will not cover the custodial costs. 

HMOs and Preventive Medicine-Health Maintenance Organization plans serve patients through a team of healthcare providers that agree to provide members with the services they need. The program covers a relatively wider diversity of preventive health services.

Members must select a PCP (primary care physician) to handle almost all their healthcare needs. Before visiting a specialist, you first have to be referred from your PCP. HMO plans are diverse, but their out-of-pocket healthcare costs are usually lower. You may need to pay a deductible before the beginning of the coverage, and the copayments are also low.

How to Keep Your Doctor and Ensure Coverage-If your coverage is Medicare Part B, you are free to visit your preferred physician if they accept a Medicare assignment. Medicare Part C may allow you to keep your physician if your specialist is in the network.

Choosing A Medicare Supplement That Works for You-While Medicare health insurance may offer great coverage, it still doesn’t cover all healthcare costs. If yours is the Original Medicare Plan and not the Medicare Advantage alternative, you can fill the gaps by acquiring a private supplemental insurance plan. Here are some crucial tips to finding a supplement plan for your healthcare needs:

Analyze the options – Medicare supplements are standardized and are used in any facility that accepts Medicare payments. You can choose from 10 currently available plans labeled alphabetically from letter A to N.

Talk to an insurance broker – Never fear to seek help from an insurance broker whenever you’re stuck. The law restricts them from charging a commission on the policy price. As such, you will end up paying the same premium as buying directly from the provider.

Three months before you your 65th birthday, the birthday month, and an additional three months afterward is your eligibility period. During this period, you are assured of coverage with no underwritings. Once the time depletes, you can still acquire an appropriate Medicare supplement plan.

While most seniors face major adjustments when transitioning to an elder-care community, Jewish seniors face additional challenges. Not only do they lose their homes, and many of their friends, but they also lose ties to their cultural heritage. This is where the Jewish Pavilion, a 501c3 non-profit, steps in. The Pavilion serves as a resource that provides room visits, festive holiday celebrations, and more to 450 Jewish residents in fifty facilities for seniors. The Jewish Pavilion promotes inclusion, and thousands of seniors of all faiths are welcomed into our programs. http://www.JewishPavilion.org.

The Orlando Senior Help Desk at the Jewish Pavilion (407-678-9363) helps thousands of callers navigate their way through the daunting senior maze, alleviating caregiver stress while giving advice on all types of elder issues. http://www.OrlandoSeniorHelpDesk.org.