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Medicare, Blind Men and an Elephant

Blind Man and ElephantLearning about Medicare is similar to the story of the blind men and the elephant. The story of differing perceptions is said to have originated in India. In the tale, several blind men are allowed to touch an elephant, but each man may touch only one part. One man touches the tusk, one a leg, one the trunk and one the tail. After they are finished, they get together and discuss what they discovered. Of course, each man’s description of the elephant is different from the others. Each man is correct, but each man is also wrong.

Medicare is much like the elephant and the blind men. Each beneficiary has his or her own perception of what Medicare is -- or what it is not. One beneficiary may focus on the cost of Medicare, the monthly premiums, and the various co-payments and co-insurance that must be paid. Another beneficiary may focus on the freedom to select a physician or other healthcare provider without having to obtain prior authorization, while yet another person may focus on the prescription drug coverage and the problems in obtaining a particular prescription drug.

Unfortunately, most Medicare beneficiaries fall into a category of Medicare “blind” because they have only felt one part of the service. Even during enrollment, beneficiaries have to understand the difference between Traditional Medicare and Medicare Advantage. They can select one, but not both. In either case, they must pay their Medicare Part B premium. In Traditional Medicare, it is usually recommended that the beneficiary purchase a Medicare Supplement plan, but in a Medicare Advantage plan, the beneficiary does not need a Medicare Supplement plan. In Traditional Medicare, the beneficiary may elect to participate in Part D, a prescription drug plan. In a Medicare Advantage plan, it is likely that prescription drug coverage is already provided and the Part D plan is unnecessary.

The impact of the initial decision the beneficiary makes at enrollment: whether to choose—Traditional Medicare or Medicare Advantage, becomes evident only afterwards. The blind man feeling the leg gets a hold of the trunk and begins to form a fuller, truer picture of what the elephant really looks like. Little by little, the outline of Medicare, like the physical outline of the elephant, becomes clearer.

CPA financial planners have the ability to open their clients’ eyes to all that Medicare entails. It is not an easy task. It requires educating themselves and their clients, but look at it this way:  would you want your clients to purchase an elephant based on only being familiar with the tail? When they get the elephant home, they realize feeding and cleaning up after the animal is not how they want to spend their retirement years.

Assist your clients with making the right Medicare decision early on … or they might invite you to come over to their house and ask you to bring a shovel. 

PFP Section members, inclusive of CPA/PFSTM credential holders, have access to a robust suite of retirement planning resources, including The CPA’s Guide to Financing Retirement Healthcare  -- a handbook I wrote explaining the basic rules of Medicare and paying for long-term care -- along with planning tools and appropriate adviser responses to commonly asked client questions. Non-members can download a free excerpt of the guide.

 

James Sullivan, CPA/PFS, Core Capital Solutions, LLC. James has been a CPA personal financial planner and investment manager for almost 30 years. His practice focuses primarily on seniors—those about to retire or those who have already retired. He has written more than 50 articles on a variety of retirement planning topics and also writes a monthly column on aging for the AICPA newsletter, CPA Insider.

 Blind Man and Elephant image via Shutterstock

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