Sixty- five or over? Read this article.
Open enrollment beginsNov.15
By Edward Marion

Q. I am over 60 years old and very active. I take dance lessons twice a week, exercise, and walk an hour everyday. I have a full time job and social life. I want to continue with this life style, I do not want to be crippled by the cost of health insurance. Please explain the choices I will have when I reach 65.

A. As people entering retirement realize it is no longer about fishing, eating, and sleeping, but instead, it is about continuing their way of life, pursuing dreams that have been on hold, and maintaining the quality of life they are accustomed to, health insurance is a hot topic. This is especially true with Medicare and how it is evolving. Open Enrollment begins November 15.

Americans can switch their Medicare Advantage plans and Prescription Drug plans, as they see fit.

Medicare allowed private industry to get involved because traditional Medicare, although it is good, lacks in certain areas.

First is the 992.00 Part A per occurrence deductible, and second is the 20 percent co- pay for doctors, surgeons, and everyone else involved in the wellness process.

For example, a one- time visit to the hospital, using a $10,000 doctor bill: The Medicare recipient pays the part A deductible (992.00), and 20 percent of the doctor bill (2,000.00.). This leaves him with an estimated bill of $2,992.

Because of these potential risks, Medicare allowed private industry into the formula to offer Americans additional insurance coverage. Two were introduced, Medi- Gap and Medicare Advantage.

Medi- Gap is based on a group of plans ranging from A to J, and each plan offers a different level of coverage. A is the least comprehensive and J is the most comprehensive. Although this may seem complex, it is simple because Medicare established exactly what each plan covers, and the provider must adhere to the rules.

During the initial Open Enrollment period, when a person turns 65, he or she can get any of the plans without health questions. After this initial window closes, he or she must pass the providers health questions. The Medi- Gap plan may be permanent.

Medicare Advantage is provided by authorized insurance companies and based on having established co- pays to minimize the risk. These plans also provide coverage in areas Medicare does not, such as vision, dental, free check- ups, and wellness plans.

These are appealing because the person gets additional coverage without having to pay additional premiums. Before signing up make sure to know the co- pays, the maximum out- of- pocket expense, and where the plan is accepted. When getting a Medicare Advantage plan a person is taken out of Medicare.

Next Plan D, prescription drugs.