Philip Moeller. Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs. Simon & Schuster. New York, N.Y. 2016. 29.
Medicare is a mixed blessing. On the one hand, it provides guaranteed coverage for Americans over age 65 or who are disabled, and the program has improved the health of millions since it was created in 1965. On the other hand, over the years Medicare has become incredibly complicated, thanks in part to efforts to privatize it, and running afoul of its sometimes arcane rules can be quite expensive. The program has many moving parts – Part A, Part B, Medicare Advantage plans (Part C), prescription drug coverage (Part D), and Medigap coverage – each with its own enrollment restrictions and costs. In short, Medicare is now so complex that expert guidance is almost essential. That’s where Get What’s Yours for Medicare comes in.
Philip Moeller, a writer and the co-author of a companion volume on Social Security, presents an engagingly written instruction manual, one that alerts those approaching the magic age of 65 of all the major pitfalls awaiting the unwary. As Moeller says, “What we don’t know about Medicare can cost us dearly.”
The book begins with the heartbreaking story of “Glen,” who retired in 2010 at age 70. He assumed that he had become a Medicare beneficiary automatically when he turned 65, and that his wife would be covered as well. For the next four years, he and his wife were healthy enough not to file any claims. Then, in 2014, his wife was diagnosed with cancer. That was when they discovered that they had no Medicare coverage, and because they had missed an enrollment period, they had to wait until the next year for coverage to begin. In the meantime, they paid for all the wife’s enormous medical bills out of pocket. Glen’s wife died before either of them could get on Medicare.
Glen is hardly alone; Moeller cites many instances of people who made costly mistakes because they didn’t know the rules, even people who consider themselves well-informed. He says that Medicare consumer counselors often hear the refrain, “no one told me.” Moeller tells you in this book, so after reading it you should have no excuses.
In addition to explaining the basics – like what Medicare covers and what it doesn’t – Moeller explains how the different parts interact with one another and with employer coverage. If you are still working, you may be able to delay enrolling in Part B and Part D, but it depends on the circumstances. In addition, you will learn your rights to appeal coverage decisions (it turns out Medicare makes lots of mistakes); the pros and cons of Medicare Advantage plans and how to assess them; and how to avoid Medigap insurers denying you coverage on the basis of preexisting conditions.
Medicare is so complicated that Moeller, who himself is a beneficiary, learned things he didn’t know in the course of writing this book, and he concedes that he still doesn’t know everything. But what he has learned and has so readably related here could save you a lot of heartache and money.