It’s that very special time of year again – when flyers, brochures and catalogues arrive daily in our mailboxes. And no, I do not mean Christmas flyers and advertisements. It is all those brochures about the “best” Medigap or Drug or Advantage Plan for those of us who are 65 and over. We are big business for multiple insurance companies. In a common-sense move, the Medicare fall enrollment period was moved up to occur before winter weather arrives and senior snowbirds begin the annual migration south/southwest.

While I make light of all the advertisements, you need to know that Medicare is now under attack by those who believe it is a “luxury” our country can no longer afford. In every Congressional budget fight, there are those who want to use the U.S. deficit as an excuse to take Medicare away completely, or limit its coverage.

Our out-of-pocket expenses would drastically increase, while many of us can barely heat our homes, put food on our tables or pay for basic life-saving medications. Those that speak of destroying or limiting Medicare want to take us back to the early 1970s. That was when I had to watch my 83-year-old grandmother skip her diabetes medication to make sure they could buy my grandfather’s daily dose of digitalis.

And just as frightening, there has been serious discussion about raising the age for Medicare eligibility from age 65 to age 67. There are many Americans in the 50-64 age bracket who have lost access to health insurance due to job loss. They are now hanging on to the fact that they will become eligible for Medicare when they reach 65. In my most bleak moments, I think those with Congressional power who want to delay Medicare until age 67 are hoping that a significant number of 65- and 66-year-olds will just die and eliminate the “problem.” Remember that by the time most of us reach Medicare age, we have had 40-plus years of weekly automatic deductions from our paychecks to fund our eventual enrollment in Medicare. This is not an “entitlement”, it is a paid-for right.

When you qualify for Medicare, you also have to think about the 20 percent of costs that basic Medicare does not cover. You need to pick the best Medigap (Supplemental) plan and Prescription Drug plan or Advantage plan that you can afford from all the choices available. Not only do you need to pick the best plan for today– but you also have to do it in anticipation of your future needs. You really are faced with thinking about your mortality because you have to consider your past medical history and your genetic predisposition to diseases from which your parents, grandparents, aunts, uncles and even your siblings may have already died. And you know, that at some future point, you are going to need medical care. Time is not on our side anymore.

Reaching age 65 and becoming eligible for Medicare is a milestone. But Medicare itself is a new world of language and terminology. Despite my years as a health professional, dealing with our family’s health insurance plan as well as the health insurance plans of others, I still needed to attend a 90-minute class at the Southern Maine Area Agency on Aging to even begin to understand Medicare Parts A and B, and Medigap (Supplemental) plans, never mind Part C (Advantage Plans) and Part D (Prescription Drug Plans). I highly recommend the class and individualized follow-up meeting for working through the maze of options.

In reality, many people who are just qualifying for Medicare have not previously had access to affordable health care, so now they must play catch-up in addressing untreated health problems. Either these folks could not afford the cost of health insurance on their own or through an employer, or they purchased health insurance with huge deductibles but no well care/prevention component. The end result is that many people reach Medicare with untreated health problems from chronic illnesses like type 2 diabetes. Significant complications like heart and coronary artery disease, kidney disease and vision loss may have been prevented if diabetes had been diagnosed and treated much earlier.

In 2012, the Affordable Care Act of 2010 ensures that the guaranteed Medicare benefits of Part A (Hospital) and Part B (Medical) for sick care will stay the same. But Part B now includes important preventive screening services (most at no charge to you) as part of your wellness visits with your doctor. The point of doing preventive screening is to complete a baseline assessment of your current health status. Based on the outcome of the assessment, you will be able to make a plan with your doctor to take the steps necessary to maintaining your health.

Next time, I will address Medicare 2012 in even more detail and how the Affordable Care Act has made it even stronger for the long term.

Maurie Hill is a resident of Standish.