Planning for Health Insurance After 65
Get help considering all your Medicare options and budgeting for your future past 65.
Reviewed by: Ed McClane, Licensed Insurance Agent. Written by: Bryan Strickland.
Changes to your health may affect your costs. Take the time to review your plan each year to ensure your benefits meet your needs and your retirement budget.
Medicare is an individual plan, so couples need to consider each individual plan. Spouse’s plans can be different based on health needs.
You can expect healthcare to be one of your largest expenses during retirement. Licensed insurance agents can help you maximize your benefits so you don’t leave any money on the table.
As you age into retirement and your golden years, it’s safe to anticipate your health won’t be the same year after year. That’s OK, but as your needs change, you should ensure that your benefits change along with them. You have the option to change your Medicare plan each year, the first plan you selected at 65 does not have to be your plan forever.
Premium vs. Out-of-Pocket
A lower premium with more out-of-pocket expenses is a valuable option when you aren’t seeing the doctor with much frequency. But if you expect to increase your visits, it may be time to consider a plan with a higher premium and lower out-of-pocket costs.
Compare Premiums and Copays
Annual premiums and copays vary across Medicare insurance plans. When it’s time to make comparisons, consider the number of visits you may have in the upcoming year and estimate the copay and coinsurance cost per visit. You may find a plan that can save you money.
Choosing insurance plans as a Medicare beneficiary is different than electing a health plan with an employer. Medicare has different parts, each providing different benefits to collectively cover the health services you’ll use throughout the year. When it’s time to make a decision about Medicare, there are several things to consider that may impact your costs:
- Your existing health status. Are you healthy or do you anticipate above-average utilization of health services?
- Are you married? Medicare is an individual plan, and your spouse will require their own coverage. The right plan for you may not be the right plan for your spouse, and choosing the right plan can save you money.
- Do you have preferred providers or specialists? If you need special care or a specific provider, review provider networks to ensure you have access to what you need. Using a plan with out-of-network services can be expensive.
Each Annual Enrollment Period (AEP) is an opportunity to evaluate your health, your coverage and your Medicare plan options to ensure you get the most out of your insurance.
Healthcare and insurance are tricky — that’s the bottom line. To be successful in planning for the future, you must understand how your health is going to factor into what will be rising utilization and costs over years of retirement. To get it right requires careful planning and the right support.
Talk to your physician
If you haven’t discussed your medical history or possible health concerns that come at certain stages of life, now is a good time. Knowing what may be coming down the road allows you to plan ahead of time and be prepared.
Benefits are what an insurance agent does
GoHealth’s licensed insurance agents are ready to build a plan for your future because they support members every day. You can receive high-quality advice that considers your health, benefits, access to networks and costs.
Your utilization may rise as you move further into your retirement years, but it doesn’t have to affect your retirement. With the right planning, your retirement years can be truly golden.
Do Medigap costs increase each year?
Medigap Insurance, just like any other insurance, has rate increases. The costs may not increase every year, but it’s wise to plan as though your premium will increase nearly every year. If you’re planning for the cost, consider that an increase is most likely to go into effect on the anniversary of your policy or the month of your birthday.
How much should I expect to pay for Medicare?
You can track the monthly premium for Medicare year-over-year, but that can leave you planning year-to-year without considering the big picture. If you want an idea of whether you’re comfortable or have some ground to make up, consider a recent study by Fidelity Investments.  According to the study, Fidelity Retiree Health Care Cost Estimate, an average retired couple age 65 may need approximately $295,000 saved (after tax) to cover health care expenses in retirement.
What does Medicare not cover?
When people think about Medicare costs, they most often consider the coverage included in the plan. But, sometimes the unpredictability of health and what’s not in your plan can end up costing much more than some extra coverage on the front end. If you wind up needing services that aren’t covered by Part A and Part B, consider options for expanding your coverage.
Some of the items and services Medicare doesn’t cover include:
- Long-term care (also called custodial care )
- Most dental care
- Eye exams related to prescribing glasses
- Cosmetic surgery
- Hearing aids and exams for fitting them
- Routine foot care
If you think you may need services Medicare doesn’t cover, you may want to consider a Medicare Advantage plan or Medicare Supplement insurance. Without additional coverage, you will need a plan to pay for some services out of pocket.