Anyone who has signed up for Medicare or is anticipating doing so in the foreseeable future knows that it can be a cumbersome and complex process, with lots of factors to consider and decisions to be made. While ample resources exist to help you understand the Medicare system, it’s always valuable to review the specifics- what are the components of Medicare, when is it necessary to sign up, what do you need to pay for and what does that cover, what’s optional to consider, and what’s left uncovered. There are also mandatory sign-up windows in addition to potential penalties if you don’t follow the rules. For some basic, up-to-date overviews, pull out your medical bills and click here and here.

Many older adults have confusion over whether to sign up for Medicare if they continue to be covered by private health insurance through their work or their spouse’s work as they approach age 65. Given the number of older adults remaining in the workplace, this is becoming a prevalent, and confusing, concern. This is especially so as Medicare permanently penalizes certain individuals who neglect to enroll during the 7-month window prior to and following their 65th birthday. Whether or not you should sign up for Medicare while working will depend on the size of your current employer and whether or not you are making use of a Health Savings Account. To find out some of the ins and outs of this coverage confusion, check out these recent articles from NerdWallet and CNBC.

Lately, in the wake of the FDA approval of the new Alzheimer’s drug Aduhelm, there has been growing alarm around the extraordinary costs of this drug (estimated to be $56,000/year). There is the potential that millions of eligible Medicare recipients might take the drug and could overwhelm the Medicare budget to the point of disaster for the entire health care system. In fact, The New York Times has compared the costs of covering this new drug to the entire budget for NASA. Some experts warn that the actual costs per person of this drug will be closer to $100,000/year, with all of the screening, infusing, and monitoring the drug will require. Separate and apart from the costs of this new medication, there is already concern about the burgeoning numbers of people about to enter the Medicare system. Estimates are that by 2030, the number of Medicare enrollees will rise by 27%, from the current 64.3 million to 81.5 million enrollees. The question is, given the tremendous costs of Aduhelm as well as other budgetary concerns, whether Medicare will need to limit access to Aduhelm, or find other cost-saving measures to protect its budget.

Finally, with regard to that budget, it’s important to understand proposals now being put forth to expand Medicare coverage to areas essential to geriatric well-being yet currently uncovered: that is, many prominent politicians are now suggesting that it’s time for Medicare to provide dental, vision, and hearing coverage, given how essential these areas of health care are to the physical and mental health of older adults. While some Medicare advantage plans currently provide limited coverage in these areas, the reality is that out-of-pocket costs for dental care or vision or hearing loss often leave older patients destitute or without proper care because they lack the resources to pay for what is actually essential. For a better understanding of these proposals and their likely passage through the current political process, pull out your magnifying glass and look here.