News and Views From my kids accomplishments, to my heretical perspective of the world

In another month and a half, I become a full-fledged senior citizen, or non-euphemistically: an old man. I’ll be 65 in March.

Perhaps the best part of hitting this milestone is that I will become eligible to receive Medicare.

The following is a little detailed, but could be useful to someone else who is approaching the 65 year mark.

There are three major and many minor decisions that have to made about Medicare. The majors are: Plain Medicare, Medicare Advantage, or Medigap?

Plain Medicare is the simplest and would probably be adequate 9 years out of 10, but in a year with major illness, multiple hospitalizations or surgeries you could run up an astronomical bill. There is no cap (maximum out of pocket) with plain Medicare.

Medicare Advantage plans basically replace Medicare with a privately run insurance plan, often costing no more than plain Medicare and often providing better coverage. But you are almost always limited to a network of doctors and hospitals in one county. If you do much traveling or prefer doctors who are not in the network, you may have to pay on your own. There are many MA plans in every county, all with different coverage, charges and networks. This type of plan works well for my mother, who never travels and has doctors who are all in her network. Her medical expenses are quite low as a result.

The third option is Medigap, or Medicare Supplemental, which is government regulated private insurance that covers the “gaps” in Medicare. This can get really confusing as there are 11 options all with slightly different coverage, but at least the options are all standardized through the country, differing only in cost from one provider to another.

For me, Medigap has several advantages over a Medicare Advantage plan.
1) I can choose any doctor or hospital I want, as long as they accept Medicare.
2) I have coverage anywhere in the country, and as I travel a lot this is important.
3) I don’t need a referral to see a specialist. I just make an appointment and go.
4) Some plans even include Foreign Travel Emergency care.

Almost half of all Medigap subscribers buy Plan F which pays all (Medicare approved) medical expenses. You might never pay another cent for medical care except Prescription drugs. Many people get pushed into this option because it pays the largest commission to insurance brokers, but this plan is very expensive and there are clearly better options.

After extensive study, simulated scenarios and calculations, I have decided to get Medigap Plan F – High Deductible. This is the same as Plan F that I described above, except that it doesn’t cover any more than plain Medicare until you have spent $2180. After you meet this deductible, all medical expenses are covered with $0 copay. The result of this high deductible is that premiums are about 1/3 of the regular Plan F (~$50/month vs. $150 at age 65, ~$100 vs. $300 at age 77 and older), and it is quite unlikely that I will spend more overall than I would have with Plan F. In fact, I expect to save $1000 – $2000 each year in total costs. Even in an exceptional year I know my expenses won’t exceed the $2180 + ~$600 annual premium. This is so much better than the current $600 per month ($7200/year) I pay for a $6000 deductible plan from the Exchange, a plan that many doctors don’t accept.

I considered Medigap Plan N, which would always be cheaper overall than Plan F, but it would cost more than Plan F – High Deductible in all but an exceptional year.

I added a Medicare Part D prescription drug plan to this too. I don’t need it at all right now and the premium will cost much more than any drug expenses I have, but if I do need expensive drugs in the future I will have to pay a large penalty to get into a drug plan. Better to pay $18/month now and be ready.

My philosophy with insurance has always been that it should be to cover expenses that I can’t afford. I can self-insure for the smaller amounts and save more on premiums than I am likely to spend on deductibles. I follow the same strategy with warranties — I’ve saved a lot more by never buying an extended warranty for any of the TVs, cars, microwaves, dishwashers, computers, monitors, printers,… than I have spent repairing or replacing the random item that has failed.

We just bought a new car for Gisele, a 2016 Honda Accord. You’ve all seen Accords before, so not much to talk about design-wise, but there are some interesting high tech features.

1) Engine and Road Noise Cancelling — There are microphones that detect the noise in the cabin and use the sound system speakers to generate cancelling sound waves to reduce the noise level. The car is very quiet, which is about all I can say.

2) Adaptive Cruise Control — I first encountered this on my 2011 Acura MDX, and loved it for highway cruising. Set the cruise control, and if you get too close to the car in front you will slow down and keep a safe distance. Makes highway cruising more relaxing.

3) Forward Collision Warning — Audible and visual warnings if the car detects you are approaching an obstacle too quickly. The next related item is much cooler.

4) Collision Mitigation Braking System — Also on my MDX. If the front radar detects that you are approaching an obstacle too quickly, it will apply brakes to slow you down and stop if necessary. I “sort-of” tried it on my MDX a few times, and it seems to work well. I think Honda would call it Collision Prevention System, but obviously it’s not going to work perfectly every time, especially if someone pulls in front of you suddenly, or you swerve into an obstacle at the last minute. So for legal purposes it is only “collision mitigation”.

5) Lane Watch — This is becoming pretty standard on a lot of newer cars — the system watches the line markings on the road and if it detects that you are moving out of your lane without using a turn signal, the car will audibly and visually warn you. Kind of cool, but the next item is even cooler.

6) Lane Keeping Assist System– The car will actively turn the steering wheel to keep you centered in the lane. It’s a little like Tesla’s new self-driving feature, but Tesla’s system is a lot more reliable, taking fairly sharp curves and accepting gaps in the lane markings. With Honda’s system there have to be markers on both side (painted lines or raised bumps), and the road can’t have any sharp curves. And if the system detects that you haven’t manually moved the steering wheel in the last 15 seconds, it will get upset and insist that you take control. They call it a safety feature, not self driving. Still, it’s pretty cool and a sign of the inevitable progression to completely self driving cars.

7) Road Departure Mitigation — Really just a subset of Active Lane Keeping that it is always enabled unless you turn it off (over 45 MPH). If you start to drift off the right side of the road without a turn signal, it will alarm and gently pull you back on the road.

8) Blind Spot Camera — When you turn on the right turn signal, the display in the dash shows the camera view on the right side of the car with lines indicating how far behind are the cars that you see. I’m not sure if I like this as well as the simple blind spot light on my MDX that would illuminate if there was a vehicle in the blind spot. That was idiot proof at a glance, whereas with the camera you have to comprehend what you are seeing. We’ll see how well it works.

9) Android Auto (or Apple Auto for Ken) — You can connect your smartphone and use many of the apps right on the car’s screen. We actually haven’t played with this much yet. I’m not sure how convenient it is and Gisele still has too much to learn with the other features. We may look at it in the future. Closely related is “Aha”, which is supposed to convert text to speech of your Facebook entries and Tweets, and also play internet radio stations you select. We haven’t tried this yet either; reviews are pretty negative anyway.

10) Eternal Traffic Monitoring — With our past couple of cars, the navigation system would show traffic conditions for three months until the Sirius satellite radio free trial expired, and then it went away. Honda includes a lifetime subscription to traffic updates that display on the navigation map, showing slow or stopped traffic, accidents and roadwork. I think they realized that Google provides a similar service for free, so people are going to be less likely to pay for it anyway. We haven’t tried it enough to know how up to date the information is.

There’s all the other, usual stuff such as back up camera, electronic vehicle stability of course.

Cars have changed a lot in the past 20 years! All this high-tech stuff that used to be only found on high-end vehicles at a large premium is now trickling down to mainstream cars. Hopefully the increased insurance premium because of the added cost of these features will be offset by a reduction in insurance premium because they should make the driver safer.

Will playing with the active steering cause more accidents than it will prevent? Will drivers pay less attention with a false sense of security? Will the bored driver fall asleep and then miss that sharp curve that the system couldn’t handle?

Will it stop you if you determinedly accelerate toward a block wall? I hope so!