Recommended Reading: Working Beyond Age 65

Although there are general rules surrounding Medicare enrollment, if you and/or your spouse remain working beyond the age of 65, the timing for enrollment in Medicare Parts A and B has some nuance to it. In addition, if you remain working and contribute to a Health Savings Account (HSA), there may be tax implications.

As always, a customized assessment of your unique situation and that of your spouse is critical to making the right decisions at the right time.

This article discusses some of the issues.

This article provides insight on speaking with your employer if you are over the age of 65 and remain working.

Finally, I’m often asked if I recommend HMO plans through the ACA marketplace or through Medicare Advantage Plans for Medicare recipients. My standard answer is, “It depends on individual circumstances.”

Overall, my goal for individuals choosing these plans is for them to fully appreciate the guidelines and restrictions involved. This allows them to work within them and to anticipate and budget for out-of-pocket costs that will occur as care is accessed.

More on this topic, here.

Recommended Reading: Medicare Costs

As we assist clients who are enrolling in Medicare for the first time, we consider many things. The articles below discuss some of those considerations.

Health Savings Accounts (HSAs) and Medicare

If you have an HSA and will soon be eligible for Medicare, it is important to understand how enrolling in Medicare will affect your HSA.


When some of our clients retire before they turn 65, they often ask about COBRA coverage in comparison to obtaining their own insurance through the Individual/Family market. There are many nuances to COBRA, and these require careful investigation as people are making choices.

Here is some general information about COBRA.

Medicare Advantage Plans

Changing the way we pay for healthcare by aligning incentives is critical to reducing cost.

This article describes some examples of the way physician groups are attempting to keep their members healthy and reduce costs for Medicare recipients.

Recommended Reading: Words Matter

Your loved one may be managing pain while in an acute care hospital or a skilled nursing facility. This discussion about the importance of using words to describe pain is very informative.

Managing communication and the sharing of accurate information when a loved one is hospitalized and then transitioned to a skilled nursing facility is fraught with opportunities for things to fall through the cracks. This discussion about the use of electronic medical records is encouraging.

Recommended Reading: Doctor-Patient Relationship

Relationship with your physician

We coach our clients to develop positive relationships with their physicians as a means of taking leadership of their own healthcare. It’s nice to see scientific research supporting the value of the “Doctor-Patient Relationship.”

David Meltzer, an economist and a primary-care physician at the University of Chicago, spoke at our National Association of Healthcare Advocacy Consultants (NAHAC) conference a few years ago.

Pre-existing Conditions

I am gravely concerned that once again, insurers will be allowed to discriminate against individuals with pre-existing conditions. As one small example, following enactment of the ACA, one of our clients’ insurance was $10,000 less because her pre-existing condition of “back strain” could no longer be used to charge her exorbitant fees. Please stay informed about this issue: