OCTOBER 2021 • LONGISLANDPRESS.COM 47
SENIOR HEALTH
NAVIGATING COVERAGE OPTIONS
The Medicare enrollment period reopens
on Oct. 15 and runs through Dec.
7, off ering 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 aft er 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
fi rm, “it is more important than ever
that seniors be able to navigate the complex
Medicare insurance market and
fi nd the plan that best fi ts their needs.”
Eff orts 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 eff ectiveness. 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 fi gures, 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, fi nd 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 fi nd 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 not 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
fi nd alternative ways to fi nance 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 oft en 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
MEDICARE ENROLLMENT GUIDE
Efforts are underway to save seniors money. (Getty Images)
"Seniors need to do
research, seek advice,
and be prepared,”
says Dave Rich.
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