Claiming  Medicare Is Just the Beginning Amid ‘Silver Tsunami’

More than 11,000 Americans will turn 65 every day this year, reaching the age when they can claim Medicare benefits.

This “silver tsunami” makes the need to decode the program’s complexity more urgent than ever, said Kimberly Lankford, a longtime AARP contributor and reporter at The Wall Street Journal. The technical details are key, but perhaps the most important lesson is a broader one: each clients’ Medicare claiming decision is only the start. Getting the most out of the program is a constant effort that doesn’t end at age 65. 

“When I first started writing on personal finance more than 25 years ago, my own retirement felt very far away,” said Lankford, who recently released a new book called Medicare 101. “Now I’m squarely in my 50s. I’ve seen firsthand how confusion about Medicare has affected my close friends and family.” 

Big Costs and Complexity 

Medicare has always been complicated, Lankford said, but recent changes to the program have increased pressure on beneficiaries. After years of expansion driven by their features and all-in-one simplicity, many Medicare Advantage plans (sold by private insurance providers and approved by Medicare) are trimming popular extras like dental, vision and over-the-counter allowances. Traditional plans, likewise, are recalibrating costs and benefits, but they remain an important choice for individuals who prioritize broad provider flexibility and fewer network constraints.

“One big change stemmed from the Inflation Reduction Act,” Lankford told Retirement Upside. “It altered Part D to improve prescription drug coverage and set an out-of-pocket maximum, which is a really great deal for some beneficiaries. But there are also nuances and questions about cost-sharing for those who don’t have expensive prescriptions.”

Even for beneficiaries with chronic conditions, if their particular drug isn’t on Part D’s schedule, which itself changes every year, then its costs aren’t subject to the maximum. It’s yet another reason that revisiting previous decisions during each year’s open enrollment is critical. One more sobering but important truth is that, even when clients make sound claiming decisions, they still face significant costs: 

• Average projected lifetime premiums for traditional Medicare options are $688,996 for a healthy 65-year-old couple retiring in 2026, according to the health spending analytics company Health View Services. 
• When deductibles, copays, hearing, vision and dental are added, total costs increase to $955,411 for Medicare Parts B and D and supplemental insurance. 

Don’t Be Passive. People may feel daunted by Medicare, Lankford concluded, but information is a source of empowerment. “Go to the website and type in your info, your drugs, your location,” she advised. “The government has good, free prediction tools that a lot of people don’t use. It’s a great place to get started, and the states all have resources as well. Get to know what plans are available in your area, and be mindful of special state-by-state rules.”