More than half a century ago, when I worked as a teen playground assistant, I paid my first Social Security and Medicare contributions that were deducted from wages.

Recently the federal government sent me a letter saying that I am about to collect on my investment. That’s good news, but in a perfect world there’s less paperwork and bureaucracy as you get older, and fewer difficult choices and confusing options.

With Social Security, you have to decide whether to start collecting lower monthly amounts in your early to mid-60s or wait for the maximum payout of 70. Either way, it’s a roll of the dice. I went for the latter, which meant leaving money on the table while worrying that 10 minutes after receiving my first check in October when I turned 70, I’d drop dead.

Medicare is a more complicated consideration. It’s been a while since I looked inside a can of alphabet soup, but we talked about that in the big bowl of Medicare options. You have to familiarize yourself with parts A and B, and also parts C and D. And then you have the Medigap plans, which complement A and B and go all the way up to plan N.

To clarify, I visited a Medicare website that offered comparisons of plans A, B, C, D, F, G, K, L, M, and N, along with this helpful tip: The Medigap policy will only pay out your coinsurance after you have paid the deductible (unless the Medigap policy also covers your deductible).

I don’t speak gibberish, but it doesn’t sound right. And it strikes me what you don’t get with basic Medicare coverage, known as parts A and B.

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I’m glad it addresses the catastrophe, said Bob Yates, a resident of Pacific Palisades who shares his thoughts with me on the joys of aging. But what health plan doesn’t cover teeth, ears, eyes, and prostate?

Exactly, and just when all those parts start to fail. The basic plan doesn’t cover recipes either, just as you realize you need a small village of plastic pill boxes.

But fear not, because vision, hearing, dental, and prescription coverage is available in one of the many Medicare Advantage plans, also known as Part C, and please don’t ask me why.

I’m not lying when I tell you that on Wednesday afternoon, as I was trying to get through all of this, I started seeing waves of bright light rolling across my computer screen. I assumed my head was going to explode, which part A would probably cover hospitalization for, but part B would need you for an aspirin.

i

reaches

a doctor who asked me to describe the symptoms.

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Do you have a headache? he asked.

Yes, I said.

He told me I had a visual aura migraine.

No doubt, and rightly so.

Beneficiaries are confused and overwhelmed by the choices, said Jeannie Fuglesten Biniek, a Medicare expert for KFF, a nonprofit health care policy organization. They are also overwhelmed by the advertisements on TV.

The Biden administration has even cracked down this year on inaccurate marketing pitches for Medicare Advantage plans, which cover about half of all beneficiaries. And some of the largest Advantage insurers have been accused of raking in billions by exploiting Medicare.

In a just world, those freeloaders would be tasked with covering the millions of people, including children, who are now at risk of losing Medicaid because the pandemic extensions have ended. But there is no just world and no perfect healthcare system, including Medicare. The good news, Fuglesten Biniek said, is that the vast majority of beneficiaries are happy with Medicare, whatever their plan.

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But which one suits me? As someone with titanium knees and a pacemaker, I want to make sure I have a fighting chance of continuing to collect Social Security checks. And I will probably need them because no Medicare plan will cover the largest medical bill many of us will ever receive long term care in nursing homes and private homes.

When I received my Social Security payment notice, the same envelope contained an updated Medicare card. I’ve had part A (hospitalization coverage) since I turned 65, and now part B (medical basis) has been added, effective 2024.

I contacted Tatiana Fassieux, a training specialist at California Health Advocates, a Medicare nonprofit, and learned two things.

First, I’ll have to pay Medicare when Part B kicks in next year, and the cost ($164.90) will be deducted monthly from my Social Security checks.

Second, I don’t need Part B as long as I’m still working and covered by employer-sponsored health care.

Don’t laugh, I didn’t know you had to pay for basic Medicare coverage. And I don’t know how I got to part B if I don’t need it. Did I make a mistake when submitting my Social Security application?

Maybe there was a box you checked, said Fassieux, advising me to call Social Security immediately.

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Before canceling Part B, I need to compare my business plan to a Medicare plan and compare premiums, limits, out-of-pocket expenses, and what is and isn’t covered. Speaking of which, it was a little unnerving to hear Fassieux, a Medicare expert, tell me that she was exhausted trying to resolve a coverage dispute involving her mother, who had fallen and was recovering.

If you’re distracted by coverage options, Fassieux said, you can call

to call

1-800-434-0222 and speak with an advisor at the state-sponsored Health Insurance Counseling and Advocacy Program. Or you can call a private Medicare insurance broker, or several, and compare. I called Judy Flowers, with Williams Insurance in Fullerton, and told her I had just entered the Medicare maze.

When people call me feeling the same way you feel now, Flowers said, it’s my job to keep them calm and see them through.

She gave me two sample options.

A Medicare Supplement Gx plan, along with a supplemental prescription plan, would cost about $400 per month. It would include vision, dentistry and hearing, and allow me to see doctors of my choice.

The second, a Medicare Advantage Plan HMO, would cost less than half and cover the basics plus vision, dentistry, hearing, and prescriptions, but limit me to a prescription network of doctors.

It’s a lot to think about, with tons of fine print about caps, co-pays and whatnot, and there are over 40 Advantage plans to choose from.

I hope at least one of them covers visual aura migraine, but for my health I try to keep calm.

steve.lopez@latimes.com