Case Study: Health Planning

This 61-year-old woman has four years until she can go on Medicare. Should she? What else does she need?

by: Maureen West, from: AARP VIVA, Fall 2011

— Photo: Dave Lauridsen/Illustration by Jon Valk

En español | Irma Almirall-Padamsee, 61, the retired director of multicultural affairs at the Samuel Johnson School of Graduate Management at Cornell University, spends 40 hours a month volunteering with cancer patients. She talks with new patients and identifies those who need buddies. She's in charge of a boutique that offers cancer patients free bras, wigs and prostheses. Puerto Rican by ancestry and fluent in Spanish, Almirall-Padamsee also translates a health column for one of the doctors.

See also: Are You Prepared for Your Future?

Those experiences have made her careful about her own health. She takes care of her asthma, high blood pressure and cholesterol through medications and diet. She sees her doctors regularly. She even keeps in her purse a list of the prescriptions that she takes.

Six years ago, Almirall-Padamsee and her husband bought long-term care insurance because their two grown children live far away and the couple doesn't want to live in a nursing home. The policy gives them some comfort, but she worries she is not seeing the whole post-65 picture.

She wonders: Will she transition from Cornell's insurance to Medicare? Will she need supplemental insurance? How does their long-term care insurance fit into the scheme? And what other types of insurance should they have in place?

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Expert Advice

Joe Baker
President, Medicare
Rights Center
New York, NY

Irma will be better off than many retirees, says Joe Baker after reviewing her Cornell University policy, which he says will supplement Medicare. He specifically liked the policy's strong drug coverage. University and big-company plans are generally worth keeping as secondary insurance, he says.

Retirees who don't have company health plans may need Medigap insurance for the 20 percent not covered by Medicare, he adds.

But Irma should check again when she's closer to 65 because Cornell, like any private employer, could change the terms of its policy — and Medicare itself could change.

She should apply for Medicare three months before she's eligible, to avoid a waiting period. He advises her to never let her long-term care policy lapse — it's very expensive to buy later. While Medicare and the Cornell policy will cover medical needs, her long-term care policy will cover costly home care or a nursing home.

Finally, Baker says, Irma should remember that while Medicare Part A is free, Part B costs $115 a month for most people.

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