Health care costs in retirement: Can you separate fact from fiction?


(BPT) - As their 65th birthday looms, many people eagerly anticipate the affordable access to health care that Medicare will provide. After all, Medicare covers everything, right? Not exactly. Because of this common misconception, many people are caught off guard when they realize that each one of the dozens of Medicare options available to them comes with its own set of out-of-pocket cost implications. In fact, a survey of the newly retired found 43 percent are spending more on health care than they had planned.

The more you know about Medicare plans and costs, the better prepared you’ll be to avoid unpleasant surprises. Think you’re savvy enough to discern myth from fact when it comes to your health care costs in retirement? Read on to put your knowledge to the test.

Myth: When comparing Medicare plans, it’s best to choose the lowest-premium option to help minimize your costs.

Fact: While premiums are an important factor when choosing a health care plan, they should not be the only factor — or necessarily the most important either. Sometimes a low monthly premium option comes with higher out-of-pocket costs or lacks benefits and services that are important to you.

It’s best to understand the total costs of a plan — including the deductibles, copays and coinsurance — as well as any benefit limitations that could increase your costs. For example, if the hospital you use isn’t in a plan’s network, you’ll likely incur higher costs if you choose to access care there. If you like to exercise and stay active, a plan that covers a fitness center membership could save you the expense of a monthly gym membership. Want to see a dentist or optometrist? Original Medicare likely won’t cover that care, meaning you’ll have to pay for it out-of-pocket, unless you choose a Medicare Advantage plan with dental and vision coverage.

Myth: If I enroll in a Medicare Advantage plan, I will pay only one premium. And if my plan has a $0 premium, I won’t have to pay any premium at all.

Fact: The simplicity of Medicare Advantage is one of the reasons enrollment in these plans has grown so dramatically. Many people appreciate the convenience of wrapping all of their Medicare coverage into one plan and having just one card in their wallet. That said, choosing Medicare Advantage doesn’t mean you’re totally off the hook in terms of paying monthly premiums. You are still responsible for paying your Part B premium. In 2018, the standard Part B premium is $134, but it may be higher or lower depending on your income.

Myth: There isn’t much you can do to contain or manage health care costs. It’s mostly up to chance or luck.

Fact: While no one can predict or completely control their future health care needs, you can take steps to protect yourself from high health care expenses. Choosing a Medicare plan that limits the amount you spend on health care costs during the year is one option to consider. Look for plans with an out-of-pocket maximum, which is the most you will pay for covered services in a year. Once you reach that amount, your plan will cover 100 percent of the cost of the Medicare-covered services you receive, and you’ll pay only your premiums. Medicare Advantage plans and two Medicare supplement plans include out-of-pocket maximums.

Medicare supplement plans can also offer some predictability in your health care costs by covering many of the costs Original Medicare doesn’t, such as coinsurance, copays and deductibles.

“Regardless of the plan you choose, everyone can stand to benefit by being proactive about taking care of their health,” said Efrem Castillo, chief medical officer of UnitedHealthcare Medicare & Retirement. “Eating a nutritious diet, exercising regularly, seeing your primary care doctor annually, getting your recommended cancer screenings and taking your medications exactly as prescribed are all steps you can take to help protect your health and possibly your wallet from the expense of managing major health issues later on.”

So how did you do? Regardless of whether you aced this test or were totally stumped, there’s much more to learn when it comes to a topic this complex.

To get smart on all things Medicare, check out MedicareMadeClear.com. The information on the site is neatly organized into categories to help you find what you’re looking for. The videos, quizzes, guides and frequently asked questions in the resources section of the site can also be helpful tools. AARP.org is another great resource. Visit the “Retirement” and “Money” sections for information that can help you better understand health care costs during retirement and how to manage and plan for them.