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.

Basal cell
carcınoma
awareness

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 Cancer Foundation.

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.

Warning signs

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 doctor immediately.

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.

Treatment

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.