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Thursday, May 29, 2008

Medicare

Do you know you are old when you get a reduced fare at a movie theater? Is it when your hair turns gray or you lose it? Is it when younger people start finding you less physically attractive? Nope, none of these. In the United States, you know when you must sign up for Medicare at age 65.

Okay, I should not say must. I guess you could pay for all insurance yourself at 65, if you could get an insurance company willing to cover you; but if you had been on a corporate, retirement package, you will have no more health insurance if you don't sign up for Medicare. In some ways, Medicare may benefit these corporations as much as anybody because they then pay less of the employee insurance costs and the government picks up some of it.

Signing up for Medicare might not be so bad if it was easy to understand and simple to make the transition. Unfortunately there is no one single program for seniors at 65. There is Medicare, Medicare Advantage, Medicare Complete, Prescription Plans Part D, Q, and Z (I made up part of that), and who knows what all else. Just for fun, look at how clearly Wikipedia explains it: Part D.

Usually when I write something here, I have thought it through. I try to be logical and present my viewpoint (even if some doubt that). No way I can do that with Medicare. It is an eight letter word of which I never liked the sound, knew was coming, now here it is, and it's as confusing as I was dreading. I am hoping others who have been through this process will write about their experiences and how they see the options.

My husband will be on Medicare as of June 1. I won't be in it until October but already I am being impacted by it as sometimes when a corporate insurance package gets changed, everything gets screwed. We shall see if that happens here.

My experience of going through transitions, which happened once before when my husband retired from his company and went onto their retirement insurance program, if there are possible glitches, there will be. There is nothing like an insurance problem to make you favor single-payer, universal health coverage for all citizens. It's scary to realize you could be on your own in a world where such care can be highly expensive, sometimes prohibitively so.

Recently I read that in Oregon some doctors are refusing to take new Medicare patients. Potentially that can lead to long drives for treatment. The reason given is Oregon has been efficient in its cost savings which means the government cut back the percentage Oregon receives which means the doctors get less than they want for their services. Guess who suffers?

For a woman who doesn't like to think about technical things, who prefers not to think much about money at all, this whole thing is frustrating. If I go online to start looking for information, I find so many sources that I can't figure out which one I should trust. The government programs don't seem to get to the bottom line unless you have a high tolerance for BS.

They say if we go with 'Medicare-Complete' (the corporate end), continuing with the retirement part of the insurance we have had for many years, our coverage won't change at all. They say it will avoid us signing up for whatever those prescription drug options are because the HMO covers it as it does now. They say by paying a higher premium, there will be no donut holes (which means time in the middle of the year where prescription drug charges went over a certain amount until they reached another amount). They say instead of paying one insurance premium each month, if we went with Medicare Advantage, we will have two payments-- one to Medicare and one to the insurance end of it.

Or some say if we go with Medicare Advantage-- and I am assuming Complete, we are not being fair to all of those who can't afford those programs and cheating those who have no corporate benefits. Some say Advantage really costs more than a combination of Medicare and the drug coverage (which by the way, it won't surprise me if the latter is someday canceled due to high costs). Some say if we went with Medicare Advantage, we will be locked into whichever insurance company we originally chose even if it later changes and becomes less desirable to us.

None of this is perhaps a big deal when you think of all the problems in the world. Well, it kind of is as it just plain confuses a person at an age where I thought we were supposed to be treated more kindly and gently (joke).

Although last year my insurance company only paid for one yearly mammogram and one costly daily prescription medication, I can't count on it staying that way. Nobody can know if they will be hit by a catastrophic medical problem from seemingly out of nowhere-- something that is increasingly likely to happen in old age. So insurance does matter to me more for what might be than what is obvious at the moment.

Do you think if Congress was forced to go onto Medicare that this would be so confusing? Just asking...

16 comments:

Diane Widler Wenzel said...

I think it is so messed up because the insurance companies are all in it to make a profit. It is boarder line criminal.

MaryContrary said...

My mother is on Medicare but does not have Medicare Advantage or its siblings. She is covered by her late husband's retirement benefits which provide very good drug coverage and she would loose it if she did enroll. It is very confusing, however, and she has spent hours on line comparing the programs available against each other and against her current plan. Ronni at Time Goes By has written about this problem often with complaints similar to yours.

OldLady Of The Hills said...

I'll be honest with you Rain...I have been on Medicare for 12 years and it is STILL a damn Mystery...It is all to depressing, for words!
I know there are advantages, etc...BUT....THIS. SHOULD. NOT. BE. SO. HARD!

Loved that Video over at Terri's....!

TorAa said...

First of all:
Thanks for supporting words regading my son's sudden Death.

Then: About realizing age
What's age? Your body changes. But your mind, keep it young. That's a very personal behaviour. I know that.
But's up to everybody's own mind.

My Son died at 40 - but experienced
more than people at the age of 90

That's something to think about;))

Dick said...

Medicare is why I moved north 4 months before I retired & commuted 82 miles each way. When I retired, Annie went onto Medicare as we couldn't keep her on the company plan that I stayed on (but had to pay my own costs, currently nearly $550/mo.) Many Docs in Wash. State also will not take new Medicare patients but will stay with you when you change, so we moved while we were both covered on my plan.

Pat is a little older than me & has been on Medicare awhile & her first husband even longer. I hit it a month ahead of you (you're just a mere child!) and will stay with what she has. We both have pretty good health for us old folks but I am going to opt for the RX coverage since, as you said, you never know when you may need it and it gets more expensive to add later. Pats & mine are both Advantage plans and the premiums are a LOT LOWER than $550/mo, even after adding in what you pay for Part B. But, Medicare has it's own hoops you have to jump through and sometimes they are mountains that you can't get over.

As to your last question, yes, I think that should happen. Rather than Congress trying to reinvent the wheel to provide universal coverage they should fix Medicare and put everyone, including members of Congress, Judges and all of the rest of the royalty, onto it. That is probably the quickest & best way to get it fixed and, although I am sure a lot would change with it, there are some advantages to staying with the devil that you know (Medicare), like for Docs.

robin andrea said...

I'm several years away from Medicare, but Roger has been on it for almost a year. The big change I noticed is that we keep getting bills from doctors offices with new balances. I never know what is being billed, what is being paid, and how it all adds up.

I absolutely think we need to have single-payer health care. There is no reason whatsoever for private health insurance to exist at all. Every dollar spent on insurance is a dollar not spent on actual health care. It's outrageous. Time to take the profit out of sickness and health.

Taradharma said...

just at the time in life that people need more care, they pull the f*cking rug out from under you. it's really a shame. I think Congress should all have to go on it for a 2 year stint, and see how they like it. I bet they'd make some changes!

Anonymous said...

Robin--My advice to you would be to assure that each bill that you receive for services are actually for services that were rendered, but not to worry about what is due them until you hear from Medicare. (BTW: I nearly threw away my first Medicare statement because the envelope looked like junk mail. I didn't know that CMS stood for Center for Medicare and Medicare Services.)

I find the Medicare statement easy to read and it should tell you how much you may be billed by the providers. If the provider bills exceed what Medicare tells you, give the provider(s) a call to chat with them about it.
Cop Car

Anonymous said...

Been there and done that......last Dec. when my husband became Medicare eligible.
I will admit...I probably am a bit ahead of the game because I did home health nursing for 18 years and they were all Medicare patients, so I got to learn and understand the system very well.
BUT....I still found it a bit confusing when it was time to get Ray signed up.
One thing I did find out and I blogged about it last fall, the Medicare Advantage was something to stay away from! So be VERY careful before signing up for that until you research it more carefully and make sure you want that. That's only for your supplement anyway. It's not your primary.
Medicare will be your primary insurance.....then if you have a supplement, all other costs will be taken from that.
ie: Ray has Medicare as his primary and then BCBS of Florida is his supplement, picking up all the other costs that Medicare doesn't cover. We pay a monthly premium for the supplement. It's not mandatory to have it, but many people who can afford it do have it.
He also got into the Presciption D plan for his meds.
I have to say......6 months into all of this, I'm very, very satisfied. No complaints whatsoever. All costs have been covered and he was pretty sick about a month ago with lots of lab tests, ultrasound, etc.
Hope you can find your way through the maze. That was what I titled that blog entry, Medicare Maze. I'm covered by Ray's insurance at Continental until I turn 65 and become Medicare eligible....So I figured I did the "dry run" getting him all squared away in 4 years, it should be a bit easier.
Terri
http://www.islandwriter.

Anonymous said...

I went on Medicare a few months ago, and was hopelessly lost in the options and jargon. Finally made a decision but have not had occasion to find out if it was the right one or not. One thing I found in talking to people about it was the misconception that it is a free program by the gov't. Not so. You pay every month for the "free" government insurance.

Joy Des Jardins said...

I don't qualify for Medicare for another 3 1/2 years, but I'm really nervous about when that time comes that I'll understand it all Rain....even though what I pay now in monthly premium payments is awful. This whole insurance mess has had me upset for a long time....since my insurance from my last job ran out. Before they do anything...they should just fix Medicare for everyone. To me that would be the best cure-all. Thanks for this post Rain....it addresses so much of what I feel about this insurance mess. I get so lost in it and all it's rhetoric.

Rain Trueax said...

Thanks to everyone for their comments and information on this important topic to everybody already old and those who will get here.

Definitely Medicare is not free and to get any kind of full coverage, you have to pay insurance companies to the point where most will not see a reduction in what it costs for premiums. It will be interesting to see if the insurance ends up as good as what we had before we got on the supposed free health care for the aged.

I know one thing that if someone thinks corporations won't get the cream off the top of any program, they aren't paying attention to how government works. The only way this can be changed is probably a total rollover in Congress and a new party system. Right now the Congress doesn't work for the people. They work for the lobbyists and will fight tooth and nail to keep it that way.

This is all why when someone says we need to elect leaders with more experience in government, I wonder what their reasoning is. It will take people thinking with a whole new way, new paradigms, and able to think out of the box to change anything. It won't be easy even then as those who have the money and power intend to keep it.

Ingineer66 said...

OK I am back from getting married in Hawaii and just have to comment on this.
First off, why is it criminal that a private company make a profit. That is what they are here to do. This is the United States and we are a capitalist society. If someone wants to live in a socialist society then there are still a few countries out there with them. One of those countries just had 70,000 people die in an earthquake. Where big government provides for everything. Maybe we are not doing so bad here after all.

Medicare is not ran by and for insurance companies, it is a government program that has been "fixed" by Congress many times. That is why it is so messed up. And many people want government to run all health care. After all they have done such a good job with the Veterans Administration Health Care. Single payer is not the answer. Personal responsibility is the answer.

Good observation Terri. Be a well informed consumer and you will do much better. We research the heck out of buying a car. We should do the same thing about buying health insurance or health and hospital services.

Good observation Winston on Medicare not being free just because it is a government program. No government program is free. Some tax payer has to pay for it. Every single penny that that government spends comes from us, one way or another.

Rain Trueax said...

Congratulations on your marriage, ingineer. Hope you and your bride have many happy years together. Hawaii sounds like a good start.

As for insurance, as I recall state employees get good health benefits. How would you like to have that rolled into everybody else at 65? You might look at this all differently if you didn't have a good program yourself.

Profits are okay if they are not exorbitant. We have a capitalistic system but supposedly it was based on true competition and the government protected people from monopolies. When a monopoly determines price, it won't be based on real cost and the consumer has no choice. Nowadays there is no protection for the consumer as both congress and the presidency are bought by lobbyists. As I have said before, it'll take overhauling the whole system to change it.

Medicare costs as much for insurance as it did before when the corporation was helping with the costs as part of a benefit. If anybody thought it was a freebie, think again...

As for the veterans, it improved a lot under Clinton and evidently is deteriorating under the Republican power grid of both houses and president. We'll see what happens after November. It had been much better from what my veteran friends tell me. Time will tell if that lasts.

I think people who have insurance don't worry about health care problems and those who don't, do... it's kind of related directly to impact.

Ingineer66 said...

Thank you for the good wishes.

Well I do have decent health benefits, but not as good as my new wife has at the private company she works for. And I pay more out of pocket than she does each month.

I am still on the fence regarding monopolies. I am a firm believer in competition and one company should never have a true monopoly, but in the global economy it is difficult for our US companies to compete against Japan or Korea incorporated. Look at Airbus in the European Union, it is almost like competing against a government organization. And here we have the government fighting to hinder big corporations.

As long as there is some competition then there will always be someone who can do the job cheaper. Once you get nationalized health care, everyone will be at the governments non-responsive mercy. Talk about a monopoly.

Ingineer66 said...

Oh and I still think not having health insurance is a choice for most people. Just like not having car insurance or renter's insurance. Life is about choices.
I know a few people that choose not to buy health insurance and one of these days they are going to wish they had it.