Finding your way through the Medicare forest

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By Evaline Auerbach

Special to the Miner

Most people are confused when they confront age 65 and eligibility for Medicare. If you are a few months away from that age, you have probably already received oodles of mail concerning the issue. You should ignore those sent by individual insurance companies until you understand the whole picture. And, by the way, it is illegal for an individual agent to contact you by phone. Tell them that and hang up!

If you have access to a computer, go to www.medicare.gov. On that site you can learn about signing up for Medicare, and finding a Medicare Advantage plan which will pay for expenses not covered in the basic premium.

Some basic principles may help you through this process :

• You are eligible for Medicare at age 65 and should apply a couple of months before your birthday. All you need is a Social Security number that indicates, by your birthdate, when you are eligible. If you don ‘t sign up for it in time, you will pay a late enrollment fee every month after you do sign up.

• Medicare premiums are basically $104.90 per month for Part B (doctors, ambulance, tests). Part A (hospitalization) is free if you have paid into Social Security. Until you are old enough to receive Social Security, you will receive a bill. However, if your income is on the low end, you may be eligible for help from Medicaid (AHCCCS in Arizona) or Medicare itself. In Pinal County, contact the Pinal-Gila Council for Senior Citizens: www.pgcsc.org or (520) 836-2758). Note: Eligibility for certain plans follows county lines so advice given for those living in Pima County may not apply to you.

• You will need a Medicare Advantage Plan or other insurance in addition to Medicare. These plans require only that you are signed up for Medicare. Your health, your prior conditions all are irrelevant.

• If you receive Veterans benefits, usually you don’t need any further insurance.

• If you are receiving medical insurance through your employer, their plan will require you to sign up for Medicare at 65 whether you are retiring or not. In most cases you will want to continue under your employers insurance plan, if eligible.

• If you work for Federal or State government, you are eligible for very good plans. They may be more expensive than private plans, but they offer more coverage than you can get with all but the most expensive private plans. Get it an keep it.

• If not covered by any of the above, you need a private Medicare Advantage plan. Do get one. You simply cannot afford, unless you are extremely lucky or very rich, to go with JUST Medicare these days. Sometimes these plans will not cost much extra: these private plans have been subsidized by Medicare to provide care based on Medicare guidelines.

• In any case, for Prescription Drug coverage, you need a private plan. Medicare itself DOES NOT cover prescriptions. You can get a “Plan C” which covers medical care and a “Plan D” which covers prescriptions, but in most cases you can get them together in one plan.

• To find the private, government subsidized, plan best suited for you,first find out which plans your best doctors accept. Then go online at the Medicare site (highly recommended- get someone to help if you don’t “do” computers). You could also find a good broker who handles multiple kinds of insurance.

• Don’t be afraid of HMOs. All the cheapest plans are HMOs. The kinks have been worked out for the most part, If you have problems, you should contact PGCSC, above.

Evaline Auerbach (15 Posts)

Born at the beginning of the just pre-baby-boom year of 1943, Evaline May Jones was a Kansan until she left, in1968, to teach at a community college campus in Centerville, IA. She grew up on a farm near Frankfort, finished a BA and MA in English education at Kansas State University and taught for a year at Washington, KS, High School and at Catholic high school in Manhattan, KS, the latter while finishing her MA. While in Iowa, she taught English and related courses (journalism, theater, photography). She also earned a Specialist degree in community college education at the University of Iowa (Iowa City) and had journalism courses at Iowa State (Ames). When arthritis in her spine became a real problem, she was advised to take a job in the Southwest, so when the first full-tiime English position at Aravaipa Campus, CAC, opened up, she applied. Although she had to convince them that she REALLY wanted to work at a campus literally on the edge of a wilderness area, she got the job. She began work at Aravaipa in the fall of 1975, moved from Kearney to Oracle in 1976 and has been in Oracle since. In Oracle, she began work with the Oracle Historical Society, was a founding member and President twice. Local history became her most-loved hobby, although she did not forget drama. She produced a play called Deadwood Dick, which became the first play for a theater troupe now known as SPATs: San Pedro Actors Troupe. It was a course taught under the auspices of CAC, but the group preferred to go ahead on their own - and are still going strong on their own. Meanwhile she married Abraham Auerbach in December 1980, in the historic Union Church, holding the reception in the Acadia Ranch Museum. She made sure they returned from their honeymoon in time to celebrate the centennial of the American Flag post office building and the installation of the history plaque (Dec. 28, 1980) They produced David in late 1982 and she took sabbatical to return to Iowa to complete a PhD (in instructional design) from May 1983 through summer of 1984. While back in Iowa City, with baby and husband in tow, she began to have more problems with the arthritis, Once back to Oracle, she was a little better, but eventually had three operations on the spine. She had to retire in 1995 on disability. Nevertheless, she continued to work at volunteer jobs: as a docent at Biosphere 2 (on her electric scooter), at the Oracle Library, at the Oracle Community Center, as a medicare counselor for the Pinal-Gila Council on Senior Citizens, and finally, back to the Oracle Historical Society. More recently she served at the Tri-Community Visitors’ Center and the Copper Corridor group, serving the Oracle through Superior area. Now, she is busy helping the Oracle Dark Skies Committee to nominate the Oracle State Park as a designated International Dark Skies Park. She has also taught some courses through CAC on local history, leading local and out-of-town people to see some of the historic places in and around Oracle. She started a small business selling books about local history which has expanded to be “Evaline’s Local Books, Oracle, etc.” Lately she has given talks on Oracle History and led groups on tours, such as a two-day tour for the Arizona Historical Society docents, coming up soon for the Arizona Historical Society Docent Council. She has written articles about history and done some reviews for local newspapers. David was off to China to work for a while and then to Boston, working in financial analysis at Boston Scientific. In March of 2011, Abe, whom she had been caring for at home for about four years as he became less able, had to enter a care home. In January of 2014, loyal and very supportive to the end - Abe passed away at Grace Manor in Oracle. Evaline plans to keep exploring history, Oracles and her own ancestry. She will continue to write and plans to travel as her own health improves.


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