Donna Schramek is looking forward to retirement on the Eastern Shore. She loves the smell of the ocean, walking on the beach, and spending time with her grandchildren.
That's why the 64-year-old Brooklyn Park administrative coordinator at Medstar Health didn't hesitate to have arthroscopic knee surgery last month.
The pain "was making me feel old," says Schramek, who plans to retire in the next two years. "It was limiting me."
Health is an important consideration as workers near retirement. From insurance changes to the latest elective surgeries and procedures, there are a multitude of decisions facing retirees.
"Many people are putting off retirement because of economic issues. We're also tending to live longer," says Dr. Steven Gambert, co-director of gerontology and geriatric medicine at the University of Maryland School of Medicine and director of geriatric medicine at the University of Maryland Medical Center. "People need to prepare ahead of time."
In general, there's no need to rush joint replacements or elective surgery, says Gambert, author of "Be Fit For Life: A Guide to Successful Aging." Retirement will offer no-pressure recovery time.
"They shouldn't be in a rush," he says. But, retirees should also not think it's "too late" to consider what might improve quality of life, whether it's a shoulder replacement to make a round of golf more enjoyable or a diet that might improve cardiovascular health.
"From a health point of view, people should not put off anything," says Gambert.
That includes researching insurance options, says Nicole Duritz, vice president for Health, Education and Outreach at AARP.
"Take the time to do your homework," says Duritz. "People spend a lot of time figuring out the best cellphone plan. … Shouldn't you put at least that much time in researching your health coverage?"
Study your options
Because most people opt for Medicare at age 65, it's important to learn about the program ahead of time, Duritz says. The 7-month enrollment period begins from three months before one's 65th birthday to three months after.
"We recommend starting the process early," she says. "There are lots of things to consider."
The biggest decision is whether to choose the original, also known as traditional Medicare, or Medicare Advantage. While it's possible to switch back and forth in open enrollment periods, the two options may differ widely in various regions. So it's advisable to consider whether you plan to spend retirement year-round in Maryland or split residency, says Duritz.
Depending on your current insurance plan, Medicare may be more or less adequate, she says. "There's the assumption that Medicare won't cover as much as employer-based insurance, but that's not necessarily true," Duritz says. "It depends."
Some retirees will chose Medicare as their primary insurance with a retiree plan or another supplemental, "wrap-around" plan. But "Medigap" insurance enrollment is only guaranteed in the first six months, Duritz points out.
In addition to meeting with the human resources person at your office, state health insurance assistance programs — know as "SHIPS" — have counselors available for individual appointments to review what insurance programs are available.
Medicare's website is also helpful for many, and AARP publishes a "Medicare for Dummies."
Medicare also publishes a handbook that, among other things, lists preventative screenings covered.
That can serve as a checklist for retirees. A "Welcome to Medicare" physical is also available in the first 12 months after beginning the program, and annual "wellness" visits are also covered. They provide a chance for your primary-care doctor to review what tests and screenings might be recommended, Duritz says.
The amount of flexibility you might want in seeing specialists will also determine the type of Medicare that's the best fit.
And older people should probably consider an evaluation by a geriatrician once they reach their 80s, or sooner if they have complicated health issues.
"It's a good idea to make sure something isn't being missed," Gambert says.
Teeth and eyes
There are some procedures one should especially consider before retirement because of Medicare limits: dental and vision.
Unless you have retiree dental benefits, it's a good idea to complete dental work before you retire, including exams, X-rays, fillings and restorative work and cleanings, says Janet Yellowitz, University of Maryland School of Dentistry's director of geriatric dentistry.
You'll also need to factor dental visits into your retirement budget.
Twice-a-year exams are ideal. Once a year is the absolute minimum, says Yellowitz. "That doesn't mean once every three years," she says.
Nerves around teeth are less sensitive as we age, Yellowitz says. "The good news is, as you age, you don't get as much dental pain. The bad news is, you can have disease and not know it."
Too often, people think if nothing hurts, there's no problem. "High blood pressure doesn't hurt either," she says. "That doesn't mean you don't need to treat it."
That's also true of vision — problems can begin before symptoms appear, says Dr. Yassine Daoud, assistant professor of ophthalmology at the Johns Hopkins School of Medicine and a cornea specialist at the Wilmer Eye Institute.
"It's very important to get a complete eye exam in your 60s," he says. "A lot of diseases start showing up then."
If cataract surgery is needed, patients can opt for a premium lens, which also corrects other vision problems and may eliminate the need for glasses, says Daoud, who recommends seeing a cornea specialist so that you have a full range of options.
A refractive lens exchange is another option, he says.
Some of these procedures will be considered elective by Medicare and insurance companies.
Another warning: patients occasionally complain that they have more wrinkles after surgery — only because they can now see them, Daoud says with a chuckle.
Consider recovery time
Whether you're considering a surgery during a slow time at work, or after retirement, be sure to factor in the recovery time.
Anita Redding, a retired emergency room nurse, wanted to go on a cruise with her friends in February. So she made sure to allow for the time she'd spend in a brace when she planned her back fusion surgery in October.
"I went on a big ship — there was a lot of walking," says Redding, 79. "But I was up to it."
She continues to work on her recovery in physical therapy. "I'm building up my endurance. … It can be a year because nerves are slow to heal."
John Kingsmore suffered from pain in his shoulder but put off surgery until the pain was severe.
After a total shoulder replacement, Kingsmore plays golf several times a week, and travels with his wife.
"It was a mistake to wait," says the 77-year-old former president of Community College of Baltimore County, Catonsville. "I wish I had done it earlier in my retirement."