2014 Medicare Costs a Mixed Bag: Medicare Planning for Retirement

Many aspects of federal Medicare remain flat for 2014, including the Part B monthly premium and the enrolled member's annual deductible, but that doesn't necessarily mean that retirees are dealing with fixed costs.

Medicare planning is one of the biggest pieces in the jigsaw puzzle that senior citizens must put together in planning for retirement, and handling their cost of living without getting a regular paycheck from an employer. When seniors talk about their retirement income and assets in relation to projected costs, many of them are talking about specific kinds of risks associated with the high costs of health care in America.

Cost protections In 2014
This year, Medicare will keep a set Part B premium of $104.90 and an annual deductible of $147. Maximum premiums for Part A will decrease slightly, to $426, although, as the report points out, the majority of seniors enrolled don't pay premiums for Part A at all.

Other protections for seniors involve various preventative services, now covered at 100%, along with the prominent resolution of the Medicare Part D "donut hole" in recent years, which significantly lowers the average costs for prescription drugs. On the other hand, reports like this also show how the Affordable Care Act will play around with some Medicare advantage plans, while the reform will also affect the cancellation of many standard private policies, and the creation of new ones that meet federal criteria.

Health-care costs for Medicare-enrolled seniors
For many retirees, issues around Medicare coverage involve a greater context and consideration of what specific kinds of costs are covered. One major aspect of care is "long-term skilled nursing care," or other kinds of facilities care where a Medicare-enrolled senior might be described as "inpatient" or cared for on a long-term basis (not inpatient in the technical hospital admission sense).

Federal government Social Security resources confirm that skilled nursing facility care is covered by Medicare Part A, but with various requirements, including the beginning of this care within 30 days from hospitalization, and a determination of medical necessity. The same guide also points out that Medicare does not cover nursing facility care unless the patient needs specific skilled nursing or rehab services.

These kinds of contingencies are an example of why many seniors end up with large bills for long-term care. Another big issue is the difference between "skilled nursing care" and "custodial care." Custodial care is often the kind of long-term care offered by nursing homes or convalescent homes, which is generally not covered. Not all certified nurse assistant or caregiver services may be covered, either.

Medicare supplements and Medigap
In order to help with their costs of care, many Medicare-enrolled seniors also purchase supplemental private insurance. According to the AHIP Center for Policy and Research, there are about  9.8 million Medigap supplemental policies in place for seniors. That number is growing as retirees look to budget for their medical costs, while avoiding the kinds of extremely complicated health-care bills that may be sent after traditional Medicare responds. In other words, seniors use a Medicare supplement as a hedge against the costs they may face after Medicare processing, for example, when technical exclusions mean that some large costs aren't covered at all -- at least, that's part of the theory behind Medicare supplements. Enrolled members need to read the supplements carefully for exclusions, as well.

Even with the best kinds of insurance coverage in place, including full Medicare Part A and a supplement, long-term care or other major health-care services can eat up a large part of a senior citizen's retirement funds and fixed income in retirement. Deductibles or co-pays can wear away at savings. One-time costs can take a chunk out of even sizable retirement assets. And meanwhile, the retired senior citizen needs to pay all other costs of living from a limited amount of income comprised of Social Security checks and whatever private savings are in a 401k or IRA account (that's excluding public workers, teachers, police workers, and others fortunate enough to get payouts from traditional pensions).

The bottom line is that retirement investors need to anticipate some kind of health-care costs, even if they are enrolled in Medicare. A realistic look at anticipating care needs, and a careful evaluation of enrollment windows, deductibles, and other aspects of senior citizen health insurance will help these individuals to protect more of the gains that they put away to fund their retirement.

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