Turning 65 can be strenuous, because you must make choices you are not familiar with. The health insurance provided by employers, while it may look the same, plays by different rules. If you don’t know the new rules, it’s easy to make the wrong choice or be misled. But it doesn’t end after your Initial Enrollment Period (IED). Each year things change, and you must stay on top of those changes to make sure:

1. You have the coverage you need for your specific needs, and…
2. That you can afford the copays and coinsurances, if any.

So, here are four (4) tips to help you make solid choices that will serve you well.

1: Find a Fiduciary Agent

You don’t have to do this on your own. Many people try to by calling Medicare and Social Security. However, keep in mind that CMS (Centers for Medicare and Medicaid Serves) and SSA (the Social Security Administration) are behemoth organizations. While they strive to provide the best service possible, they are not designed to provide one-on-one consultative services. That’s why Medicare Insurance Specialists exist.

You want to find your own agent. I believe many people think that an agent costs money, like a realtor, for example, which is why they try to do it themselves. Agents charge you nothing. Their job is to provide you with the information, so you can make the best choice. They do not choose for you; they only guide you. Then when you choose, they help you enroll – period.

When choosing an agent, there are two kinds of agents: captured agents and contracted agents.

• A captured agent represents the insurance company that hired him or her.
• A contracted agent is not captured by any carrier, but contracts with multiple to have a well-balanced portfolio from which to dip into, to better serve your needs.

While both agents will do their absolute best to help you, a captured agent can only offer you what his or her carrier has. While the contracted agent, being a fiduciary, is bound by law to look only after your best interest, and no one else’s. By having a portfolio of companies to chose from, they find the right fit for your needs.

2: If You’re Turning 65, Do an Assessment. If already on Medicare, Do an Annual Assessment.

Before choosing any plan, you need to look at everything:

• Family health history – are there any conditions you feel you may inherit from your parents or grandparents that you want to make sure you have coverage for?
• Your current health condition – do you have any conditions like diabetes, prior bouts with cancer, autoimmune conditions like lupus, sarcoidosis or other illness that would require specialized ongoing treatment?
• Your finances – how much do you earn annually and how large is your household? You may qualify for special programs that will help pay for many services, saving you thousands of dollars annually.
• Lifestyle – do you travel a lot or are you a snowbird (live up north during the summer and down south in the winter)? You may need coverage you can take with you anywhere.

The answers to these questions determine which plan is best for you. Should you go with an HMO, PPO, a D-SNP, C-SNP or MediGap plan. While all those acronyms may not mean much to you now, your agent will make sure you understand each so you can choose the most beneficial one.

Just because you did an assessment the first year you were eligible, doesn’t mean you are done. You want to an annual assessment. Your circumstances may not have changed, but plan benefits may have changed.

You will want to find out if next year’s plans have removed any benefits, raised copays, added benefits you would like to have, etc. If nothing has changed, great! If things have changed, your agent can help find the right fit, again, and help you make the switch.