I’LL BE TURNING 65 this year, so I’ve been researching my Medicare options. Even though I work in health care—and many of my patients are on Medicare—the task of choosing a plan is no less onerous for me.
I’ve read the information provided on Medicare.gov and watched numerous YouTube videos from insurance brokers. These brokers tend to support two types of Medicare coverage. Retirees might opt for a bundle that includes Medicare Part A,
I CAN’T TAKE IT ANY more: I need to rant about health care.
There’s absolutely no reason to continue the current health-care payment system, none, not one. Where’s the rationale for having private insurance, Obamacare, Medicare, Medicaid, TRICARE and the Children’s Health Insurance Program (CHIP)? Each was developed to deal with the same issue—paying for health care.
Some form of Medicare for all, or M4A as it’s sometimes known, is the only system that makes sense.
IN THE 1980s, I SPENT nearly 12 weeks in an Australian hospital. I learned that language is not always universal. I was a corporate auditor for General Electric, and the company had sent me to Australia for a three-month assignment. To Yankee ears, Australians have an accent. But at least we speak the same language. Or so I thought.
Within a week of getting to Australia, I was diagnosed with subacute bacterial endocarditis (SBE),
I GREW UP IN ENGLAND, with health-care coverage provided by the National Health Service, so I’m extremely sympathetic to people calling for “Medicare for All.” Still, I do wonder whether they realize that Medicare is neither cheap nor simple. My medical costs in 2021 were more than $10,000, with half of that for a single drug. And it would have been even more without the $3,000 a year kicked in by my former employer.
AS A FAMILY MEDICINE physician associate, I frequently meet with patients early in the new year who are upset. The reason: They just learned their medications are no longer covered by their insurance or will cost significantly more than before. Many times, the insurance company will send them a letter providing other options to consider. I work with patients to find a generic substitute that isn’t as costly.
Several years ago, I had an elderly gentleman in our office one morning complaining that he was having difficulty urinating.
WE HAVE A MEDICAL profession apparently wedded to the notion that quantity trumps quality. That’s why, although I have no problem with being dead, I have serious concerns about the process of becoming dead. I have no wish to linger for months attached to tubes, or to disappear for years into the mists of dementia.
I have few childhood memories, and I wouldn’t swear to the accuracy of those I have. Still, one from my teens has remained with me.
PUBLIC SPEAKING WAS my nemesis throughout my academic career. Though I found it frightening, I’d always been able to tough my way through the lectures and avoid a full-blown anxiety attack. Then, during a theories of psychotherapy seminar for psychiatry residents, the panic broke through.
Though only my first diagnosable episode, it portended an affliction far more sinister. It was a premorbid symptom of an underlying depression that would topple my career, derail my investment ambitions,
JOINT REPLACEMENT surgery is a rite of passage for many retirees. I’d be willing to wager that a majority of HumbleDollar readers have either had one themselves or know someone who has.
The American Academy of Orthopaedic Surgeons says hip and knee replacements are the most common types of total joint replacement. From 2012 to 2021, 2.55 million of these procedures were performed, according to the American Joint Replacement Registry, which is the academy’s data repository.
WHEN I STARTED winding down my psychology practice two years ago, I anticipated freeing up oodles of time for reflection and for hobbies long cast aside, such as collecting oldies albums and the coveted rookie cards of sports legends. But my patient hours were merely replaced by my own spiraling doctor visits.
I was disappointed and concerned about my declining medical status. Still, I was reassured by the reputation of my health insurance company and the comprehensiveness of my policy.
WHEN I TOLD MY employer I was retiring, I received phone calls from coworkers I hadn’t heard from in years. One of them was Peter. We were hired about the same time.
Peter congratulated me, and said he’d be retiring too—if he’d joined the company’s pension plan. For some reason, like a few of my other coworkers, he never took advantage of the benefit, which required employees to make regular payroll contributions.
Peter did retire about five years later.
FOR FOLKS WHO HAVE retired, but aren’t yet age 65 and hence eligible for Medicare, health insurance can be a major concern. These folks typically aren’t covered by their old employer and are now searching for individual health insurance. The good news: There’s a tax credit available—one that I believe doesn’t get enough attention.
The advance premium tax credit, or APTC, is a credit you can take in advance of filing your taxes. It’s used to reduce your monthly medical insurance premiums.
I’M AMAZED BY the opinions expressed by some retirees about the Medicare premium surcharge known as IRMAA, short for income-related monthly adjustment amount. Is it really unfair for higher-income older Americans to pay larger premiums for Medicare Part B and Part D? Many people think so.
IRMAA was part of 2003’s Medicare Modernization Act and took effect in 2007. The threshold at which IRMAA kicks in for a couple is four times higher than the median household income for Americans age 65 and older.
I’LL TURN AGE 72 this year. Since I’ve retired, my wife and I have had some wonderful experiences. Our travel adventures are full of great memories that I’ll cherish for the rest of my life.
Still, as great as those adventures have been, they aren’t nearly as important to our happiness as living a healthy, pain-free life without physical or mental limitations. That’s something that’s hard to beat. It gives you a different outlook.
I’LL BE ENROLLING IN Medicare in a couple of years. I wish I knew how much my premiums will be, but that’s a mystery worthy of Sherlock Holmes. I’ve researched it thoroughly, as you shall see, and it all starts with something called IRMAA.
IRMAA is not the name of my seventh-grade crush. Instead, it stands for income-related monthly adjustment amount. It’s the premium surcharge that people with higher incomes pay for Medicare.
How much is the surcharge?
I RECENTLY WROTE about things we can do to protect our finances in the event we suffer cognitive decline. This may not be anybody’s favorite subject, but it’s an important one.
Many of us have first-hand experience with the ravages of dementia. It can upend a carefully crafted retirement plan and necessitate costly medical care. Like many of my friends and colleagues, I’d like to know if there are things I can do to prevent or forestall the onset of mental decline.