The Third Third

The Age of Medicare

It is tempting these days to believe that all government health care insurance websites have been designed to make you sick. (And angry and frustrated and disappointed and a concerned about (1) your coverage and (2) the competency of your government.) Or in the case of Medicare, simply addled by old age and too confused to make intelligent choices. In the case of Medicare, however, the website can actually be quite helpful, even useful.  It’s actually easy to sign up for Medicare Parts A and B.  And with appropriate guidance, much of which is also on the site, one can effect the necessary supplemental insurance programs.  Or, as I have recently shouted from the rooftops, “I did it!”   It was different last year, when I first qualified. Then the vast number of variables fueled my uncertainty and made the supplemental choices seem so difficult that I simply didn’t make them.  I signed up for Medicare Parts A and B, as required, and maintained the gold standard coverage offered by my husband’s law firm as my supplemental policy, albeit at gold standard prices.  I knew I was leaving a lot of money on the table and I resented it, but I was psychologically unable to relinquish the sense of control I imagined I had with my own very good insurance backing up the government-issued Medicare. This year, with both my husband and I required to take Medicare Parts A & B and qualified for Medicare Supplemental Insurance and Prescription Drug plans, the cost differential (of between $6000 and $12,000 a year) got to me and I dove back into the Medicare (and the state health insurance and the independent insurers’) website(s) to try to make some more financially responsible choices. It wasn’t easy, and I called for help.  My husband, who joined Medicare three months behind me and was therefore three months behind in the development of his thinking about all this, was still clinging to the firm’s insurance he knew and loved, so he was no help.  But then a former partner of his offered his analysis of the same cost savings I projected, and he suddenly became more interested.   The best help, however, came from an insurance agent whose job it is (obviously) to sell the Medicare Supplement and Prescription Drug policies, but whose vocation -- and I truly appreciate this -- seems to be to help people 65 and over thoroughly understand their options so that they can, if so inclined, purchase policies that meet their specific needs.  Her knowledge was comprehensive and her assistance, invaluable.  She could make the same website I had stumbled through *sing* with reasonable, personalized options and meaningful comparisons of coverage and cost. The other thing that happened was that I began to deal with these new (to me) realities:  (1)  I actually don’t have any more control over the elements of my law firm-secured health insurance than I would over any other; (2) Medicare does not mean free or necessarily inexpensive health care insurance once you reach 65; if you can afford it, you’re going to have to pay for a lot of it;  and (3) The cost of prescription drugs is onerous and, in some cases, compounded by prejudicial insurance coverage. Most plans won’t pay much for brand names, several women-only drugs never make it to the formulary, and the policies seems stacked against mental health drugs.  In addition, you have to compare policies -- closely -- to find the best coverage for diabetes-related, or asthma-related drugs, for example.  You can fight this -- but not while enrolling;  it just is what it is.   But it *is* manageable, especially with help from someone who knows how to navigate the site.  And, while getting *off *the law firm’s insurance is an irreversible decision now that my husband is retired, getting *on* to any of the other plans is a year-by-year decision -- so that, if we make a mistake calculating the costs, or if our needs change, particularly for different prescription drugs, we can make adjustments the next fall during the annual open enrollment period. The only problem now is that we’re talking about this all the time!  In part, it’s because it’s easy to (erroneously) conflate the Medicare challenges with the challenges -- and to feel a little added insecurity as a result.  But it has to stop.  As I tell my husband, listening to him proclaim his newfound knowledge of the World(s) of Medicare makes him sound too old!   RESOURCES:
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