“Will Medicare exist in 10 years?”
It’s a question that looms heavy in the minds of retirees and retirement-minded individuals across the country – and with good reason. Much like Social Security, many people are concerned about the future of Medicare – whether it will still exist in 10 years, what it will cover when you need it and how you can build a reliable retirement plan when Medicare feels like such a wild card.
Today, we’re going to explore common questions (and answers) you may have about Medicare – let’s dive in.
First Things First: What Exactly is Medicare?
Medicare is a federally funded program that supplements medical costs for eligible seniors and those with certain disabilities. Nearly 66 million people collect Medicare as of 2023, with that number on the rise.
The benefits are split into a few main categories: Part A, B and D. These cover hospital care, general medical expenses and prescription costs, respectively. Depending on your situation, you may need to enroll for each Part individually, or you may be automatically enrolled. For example, those who receive Social Security benefits are enrolled in Medicare Parts A and B automatically and need not apply.
There’s also Medicare Advantage (Part C), which essentially combines Parts A and B within a third-party, pre-approved network of insurance providers.
Many working individuals pay into Medicare through a tax taken out of their paychecks. You can start applying for and collecting between three months before and after your 65th birthday.
Will Medicare Exist in 10 Years?
While fear-mongering headlines say Medicare will go broke in the next 10 years, that’s probably not the case – but changes are almost definitely on the horizon.
Currently, Medicare is slated to be able to cover everything they already cover for the next five years. At that point, it will be able to cover 90% of services until 2046, when it will drop to 80%. That may sound like it’s winding down, but then it is slated to go back up to 93% by 2096.
Chances are it won’t play out like that.
Congress is always talking about new ways to fund Medicare and Social Security programs. That being said, the prospect of letting Medicare die on his or her watch won’t appeal to any president, so while the future of Medicare may feel uncertain at times, we do not expect it to go anywhere anytime soon.
What Does Medicare Cover?
Medicare has pretty clear boundaries around what it will cover. Basically, Parts A & B cover emergency and preventive healthcare – nothing more, nothing less. No vision, no hearing, no dental (except in rare circumstances).
In 1999, Medicare Advantage (Part C) came on the scene and offered private insurance coverage with the backing of the federal government. It promised broader coverage and lower costs.
While it’s largely accomplished those goals, there have been complications. For example, those enrolled in an Advantage Plan can only see medical providers within that plan’s network, which can cause a hiccup if you have a doctor or provider you’d like to continue seeing. These plans can also vary widely and change over time.
In addition, some healthcare providers have begun pushing back on Medicare Advantage. For instance, over in Bend, Oregon, one healthcare system announced in October that it will no longer be an in-network provider for Medicare Advantage plans from Humana, HealthNet and WellCare due to red tape and uncertain coverage. (On the other hand, some of you might recall the attention a local clinic in Corvallis received last year for recommending Original Medicare patients switch to Medicare Advantage).
So, when it comes to knowing whether Medicare will cover you, our suggestion is that you always – to whatever extent you can – check if your treatment is covered before signing on any dotted lines (especially if you have Medicare Advantage or specific healthcare needs).
How Should Medicare Factor into My Retirement Plan?
As far as how you can build a reliable retirement plan with the variable of Medicare, the answer depends on your situation. If you want to know how it might affect your retirement plan, it’s best to connect with an experienced financial planner who can look at your entire financial and retirement goals.
Working with a financial professional can be especially helpful if you think you’ll have significant health care costs during retirement, like long-term care needs or ongoing treatment.
Where Can I Get Help if I Have More Questions?
We are pretty fortunate in Oregon to have a volunteer-based group of insurance consultants known as SHIBA – Senior Healthcare Insurance Benefits Assistance. The professionals at SHIBA provide counseling for anyone who uses Medicare or is considering doing so.
We have enlisted the help of SHIBA for client events and recommended them as a resource for clients in the past, so we feel confident pointing you in their direction if you have questions!
If you’re concerned about the future of Medicare, taking time to explore the above questions and answers can lend further insight and help you prepare for your retirement needs.
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