BY PHILIP MOELLER
SINCE ITS creation
more than 50 years ago,
Medicare has become an
invaluable program that
today provides high-quality health care at reasonable prices to its 55
million beneficiaries, a
group comprising 45 million older and 10 million disabled Americans.
Along the way, however, Medicare also
has become numbingly complicated, with a
bewildering number of programs and a seemingly infinite number of rules. Many people
struggle to make Medicare decisions and,
once they’ve selected one set of Medicare
plans, often are reluctant to change their mind
even if better choices present themselves.
While I can’t promise to make Medicare
simple, I can set out three general truths
about Medicare that can help you navigate
the program and achieve the best possible
care at the least possible price.
Enroll at the right time. Medicare has
several enrollment periods. You need to use
the right one.
For example, many people think they
enroll when they turn 65. But they don’t need
to sign up so long as they are working and
have a group health plan from their employer.
They can enroll when their employment is
about to end.
There are special enrollment periods that
apply to people in other circumstances, such
as losing a job, getting a divorce or experiencing another life-changing event.
There also is a general enrollment period
and, as noted below, an open enrollment
period. Make Google your friend. Search the
terms “open enrollment,” “general enroll-
ment” and “special enrollment” and under-
stand what they mean and if they apply to you.
There can be lifetime financial penalties
that can boost premiums by 10 percent or
more each year you’re late in enrolling in
Medicare on a timely basis. Worse, failing to
enroll properly could leave you with no health
coverage and thus unprepared should you
need costly care.
Choose the right mix of Medicare
coverage. There are two main paths here.
One is Original Medicare (Parts A and B),
perhaps with a Medigap supplemental policy,
plus a Part D prescription drug plan. The
other is a Medicare Advantage plan, usually
including a Part D plan.
Each path has its pluses and minuses.
What’s right for you might not be right for
your spouse. That’s another surprise for couples who have been covered on a family plan
through the workplace. There is no Medicare
family plan. Every person must have his or
her own Medicare insurance.
Understand what these various parts of
Medicare cover and how to use them.
Having the best Medicare package won’t take
you far unless you understand how to use
your insurance. Don’t wait for an adverse
health event to find out. Talk to your health
care providers and your friends. Read your
policies, or at least their summary sections. C
Philip Moeller authors the “Ask Phil” Medicare
column for PBS. His book Get What’s Yours
for Medicare (Item #122681) is available 10/4
at most Costco warehouses. For more about
Medicare planning, see the Pharmacy Update
article on page 103.
EACH YEAR MORE than 4 million cases of
basal cell carcinoma (BCC) are diagnosed in
the U.S., making it the most frequently
occurring skin cancer, according to the Skin
The good news about BCC is that, except
in rare cases, it almost never spreads beyond
its original site, nor does it become life-threat-ening. However, it does need prompt attention because it is potentially disfiguring.
Caused by ultraviolet (UV) radiation
found in sunlight and in commercial tanning
equipment, BCC occurs on the parts of the
body usually exposed to the sun, such as the
head, face, neck, hands, legs and arms.
Who is at risk?
• Anyone with a history of sun exposure.
• Highest risk: fair skin.
• Older people are most often affected.
• More men than women get BCC.
• Those already treated for BCC are
at risk for recurrence, typically within
two years following surgery.
Two or more of these signs might be seen
in the same lesion. If you observe these or
other skin changes, you should talk to your
Open sore. Might bleed or ooze; can
crust over. Persistent non-healing sore, possibly remaining open for a few weeks, healing
and then bleeding again.
Reddish patch or irritated skin.
Sometimes crusting over; may itch or hurt.
Shiny bump or nodule. Pearly and clear,
often pink, red or white; in people with darker
skin may appear tan, black or brown.
Pink growth. May have a slightly elevated
rolled border and a crusted indentation.
Scar-like area. Area appears white, yellow or waxy, often with poorly defined borders; shiny and tight skin.
After BCC is confirmed by biopsy, there
are several treatment options, depending on
the size, shape, location and depth of penetration. Treatment is usually as an outpatient,
and pain during and following these procedures is usually minimal.
• Skin Cancer Foundation,
• Centers for Disease Control
• American Cancer Society,
Medicare made simpler
FOR YOUR HEALTH