As you near age 65, prepare to become popular — at least among health insurers. Medicare Advantage providers will stuff your mailbox with offers that sound too good to be true, endorsed by trusted celebrities like Joe Namath and William Shatner, says Diane Omdahl, a Medicare expert and registered nurse.

Don’t fall for it or expect healthcare decisions to be easy, says Omdahl in “Medicare for You” (Humanix Books, 2023). A thorough book with an easy-to-follow contents page and index, the book educates readers on the crucial information they need to know when signing up for Medicare and auxiliary insurance for everything from prescription drugs to dental, vision, hearing, long-term care, and more.

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People’s biggest misconception about Medicare? Contrary to what Sen. Bernie Sanders, I-Vt., has led people to believe, Omdahl says, it’s not free.

Medicare also requires people to make a number of important decisions that should be based on what medical conditions they could face in the future — not on what their spouse selected or their friends say is good.

“Make your own decisions. One size does not fit all,” Omdahl says. “Go past the premiums and extra benefits and figure out how Medicare will work for you, not only at age 65 but 15, 20 years down the road. Also: Don’t put it on autopilot. Pay attention to changes in coverage and costs.”

Another important consideration for people near the Medicare standard starting age of 65 is that they have a limited window to enroll, from three months before their birthday through three months after, Omdahl notes. If they miss this initial enrollment period, they will have to wait until the following January 1 to enroll.

For the majority of people, if they miss out on enrolling for 12 months or longer, they will face a penalty. “This is not the worst mistake to make in and of itself, but if, during the gap, a person faces a medical catastrophe, it could be a financial catastrophe as well,” Omdahl says.

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Medicare Part A (covering hospitalization) and Part B (doctor appointments and outpatient care) have few prior authorization requirements. However, for those enrolled in Medicare Advantage, requirements for pre-authorization to see a doctor are a rude awakening, she says. Medicare Advantage, and even many employer healthcare plans, are increasingly requiring prior authorization before paying for doctor visits or hospital stays, Omdahl says.

“A concern many beneficiaries have is that it is controlling and limiting care,” she says.

For example, say you sprain your ankle and want to get physical therapy. It could take a Medicare Advantage plan two weeks to approve that, so in the meanwhile, you would have to pay for it out of pocket, and by the time Medicare approves the therapy, you could be healed.

“A lot of studies have shown that Medicare Advantage plans delay prior authorization,” Omdahl says.

Another piece of advice Omdahl has for those selecting a Medicare Advantage plan, which covers such important care as dental and vision, is to look at the terms of the services and out-of-pocket costs.

Fifty percent of Medicare beneficiaries opt for Medicare Advantage plans, which are network-based. Some plans will not pay for non-emergency services out-of-network.

Another very important thing Medicare Advantage beneficiaries need to know is that there are two open enrollment periods in which they can make changes. They are the seven weeks from Oct. 15 to Dec. 7 and the 12 weeks from Jan. 1 to March 31.

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One additional piece of essential but basic advice: Document healthcare coverage and expenditures meticulously, not just to partner better with your physicians but to be able to refute Medicare and other insurance coverage that falls short, or if you make a mistake.

“Tracking expenses is important to determine where you stand with regard to deductibles or out-of-pocket maximums,” Omdahl says.

In short, the expert says, her goal is to help people get the most they possibly can out of Medicare — for themselves and their families — because healthcare costs often are the biggest expenses a person will face in retirement.

According to Fidelity Investments, a single person age 65 in 2023 may need approximately $157,500 saved, after tax, to cover healthcare expenses in retirement. An average retired couple age 65 in 2023 may need approximately $315,000.

People spend 14 hours shopping for a car, Omdahl says. However, with Medicare, people often want a quick answer. Delving into what Medicare can and cannot offer you is painful, she admits, but very important. Unlike a car, you have to live with Medicare for a very long time.

“Medicare for You” at least takes away some of that pain.

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