Medicare (Part 2)

African Daisy

Today, we met with Colton, our Medicare broker. Broker being the fancy name for insurance agent. He works for us, but gets paid by the insurance companies. The insurance companies have factored in the cost of a broker, into all their premiums. So, in a sense you are paying for a broker, if you use one or not. After the seminar that he held last week, it was natural for us to choose him. In the seminar, he dispensed general information, but when we met him today, at Panera, it was all about us.

It looks like we’ll be going with basic Medicare (Parts A & B). This is pretty much a gimme. We are going to go the Supplemental route (Plan G). We chose this over the Advantage path, for two reasons. First, because we do so much traveling. The Supplemental route is good nationwide, where as the Advantage plans are more regional. The other distinction is that it is easier to go from a Supplemental plan to an Advantage plan than visa versa, because other than at initial Medicare enrollment there are qualifying medical questions that you have to answer to be accepted into a Supplemental plan.

We chose Plan G over Plan F, the other most popular Supplemental plan that is available, because starting next year, all Plan F insurances will stop accepting new customers. If you are already enrolled in Plan F, you can keep it, but we fear that over time the dwindling and ageing insurance pool will lead to higher insurance costs.

Finally, Colton was able to find the most affordable Part D plan for Anne. Due to a miscommunication, my Part D requires another iteration, but there is still plenty of time for that. I haven’t even received my Medicare card yet.

In the end, we will get Medicare health insurance for less than half of what we are now spending on premiums for Obamacare and with much lower co-pays and deductibles too. It sounds like a win-win, because we have been carrying Obamacare insurance primarily as bankruptcy insurance, hoping that we don’t ever have to use it, because using it would double our costs. Plus, that means you are sick or injured. We’ve been lucky. Let’s hope that our luck holds.

Medicare for One

Tree of Life Window, Frank Lloyd Wright, 1904

We are currently wrestling with Medicare. In this struggle, my old lady is on point, but I am not too far behind. We are racing to make sense of this mess, so that we can switchover from Obamacare to Medicare on time. We have been receiving plenty of help in this endeavor. Daily mountains of mailings arrive, all with the single underlying message, pick me. Then there are the calls. We haven’t exactly been idle, but the clock is ticking and time is starting to run out, at least for one of us. I still have the luxury of relative youth, plus the added benefit of being able to learn from the experiences, both good and bad, of others.

I shouldn’t really be so surprised at the byzantine nature of Medicare. It is a huge bureaucracy, second only to the Department of Defense. Birthed in discord and fought over by Congress since its inception, every part of it bears the hallmark of compromise and there are very many parts and even more plans. More on that later. Please hold your questions until the end, but think wheels within wheels. Compared to it, Obamacare was a walk in the park.

Anne already has her Medicare card or at least one. She can collect all three and win! Or instead, choose one card to rule them all. My application is still under evaluation, having only been made last week. These things take time and she is way ahead of me on this, but she’s older too or did I mention that already?

To help make sense of all this nonsense, we attended a seminar last night. It was held at the hospital where David was born. It too was a bit of a sales pitch, but was much more low-key than the financial retirement course that we took, a few years back, whose underlying message was, [Fear] only we can save you [Fear]. The speaker was a capable lad. His mission was to plow through eighty charts, in just one hour, with questions, lots of questions. After a few charts, he went off teleprompter, answering questions and speaking more extemporaneously.

Things that I learned: Everything that at least two names. Why? Just because. If it’s a Part it is from the government. If it’s a Plan, it is private insurance. Well mostly, please see Part C below. The “donut hole” still exists and it isn’t going away. Trust a broker. Why? Because they said so, besides it’s “free”.

Both Anne and I have our online Social Security accounts. Wait, how does Social Security enter into all this? It’s complicated, just do it. With your Social Security account you can then apply for Medicare. I have applied and am now waiting. Anne has already applied, has a card for Parts A & B, a Medicare number and most importantly a Medicare login. She has even gotten her first bill already. Now she has to decide which path to follow, Supplement or Advantage.

With Supplement she needs to collect two more cards. One for Part D (drugs) and one for Plan A, B, C, D, F (maybe), G (probably), K, L, M or N. If she gets all three she wins! Or, she could chuck it all and elect to take advantage of Part C, which really is a plan, but is not the same as the Plan C just mentioned above. Got it? Moving on. In this case she would just have one card to rule them all. Now Anne has compiled a list, a very little list of the 51 plans that are available here. That’s just one Plan C card short of a full deck.

She has just two weeks to decide what she wants to do. Really only one, because of travel. No really, more than four months, but at a higher cost. I have even longer, because I am so much younger, but I really shouldn’t keep harping on that, because she might see this and not be so amused as I. 

Doctor, Doctor Please

Danger Live Wire!

Went to the doctor today for a checkup. He seemed distracted though. At the appointment’s end, he informed me that he had prescribed me a narcotic. Then he said that he had cancelled the prescription. He had tried to prescribe the drugs for another patient and thought that he was in that patient’s digital chart, but instead he was in my chart. He had to call the pharmacy to cancel the errant script.

This little mix-up in part explains why he was so late in seeing me today, but it doesn’t bode well for the future. He has been my doctor for thirty years. He is about my age or maybe a little younger. I can remember him when Obamacare first began to work its way into his office. He was not shy about making his displeasure with it known. One of its stipulations was the requirement to make all medical records digital. I can remember those appointments. Him hunched over the keyboard, paying more attention to his new robot overlord than me his long time patient. Now he has a medical technician interview me first and she does most of the heavy digital lifting and he is back to concentrating on his patients. It is human to error, but it takes a computer to really screw things up.

Before I was ushered into the little examining room, while I was still in the waiting room, some of the other patients were remarking on a display that announced the newest doctor who was joining the practice. They were surprised with how young he looked, like “right out of high school.” Like my dentist of similar longevity, who retired this year, I expect that my doctor will soon be gone too. Isn’t that just dandy. Just when you get to an age when you might really need a doctor, they up and retire on you.

Phlegm

Un-Phlegmatic Plasma

Thick, viscous and secreted, medieval medicine once believed it to be one of the four bodily humors. I don’t even want to know what the other three were, but today it is no laughing matter, what with it coating both my mucous membranes and respiratory passages with its thick gelatinous goo. Produced in excessive and abnormal quantities, it comes in colors bright and pleasant, like green and yellow iridescent, sometimes flecked with red. TMI? Just wait, there’s more.

Inspiration for this post occurred this morning, while I was blowing my nose. In addition to producing some of this not quite liquid, but neither entirely solid substance, I also produced a somewhat painful under pressure within my ears. This novel situation took some time to right itself, until when with a loud pop equilibrium was once again restored. It felt like I had blown my brains out, only they had gotten stuck halfway out and were trying to get back inside my head. I was more careful the next time and first cried out in warning, “thar she blows.”

Wiki has a confusing and somewhat convoluted differentiation between phlegm, mucus and sputum, but I love its description of the stuff as juicy secretions. It almost sounds positively scrumptious. It goes on to say that phlegm is composed of high-molecular weight glycoproteins, viruses, bacteria, other debris, flotsam and jetsam, sloughed-off inflammatory cells and impure thoughts. Tell me that it’s snot true. While proofing this post, Anne suggested that I shorten it to just a photo, because its title alone is enough, but I can’t agree with my muse, cause I feel the need to share it all, with everyone. Group hug?

Early ACA Shopping

Late Shoppers – Honey and Bumble bee

We are expecting our first frost this weekend and in preparation for this event, I lowered all of the storm windows and then I headed over to the gardens to catch the last breath of summer. It was a wee bit chilly. Earlier, I had discovered that the Obamacare website has gone live with the 2018 plans and pricing. You can only window shop now. You’ll have to wait until next week to actually sign up for a plan. In Saint Louis, there are two health insurance providers on the ACA exchange, which is better than I had expected. I thought that there would only be one. They offer a total of ten plans, 3 bronze, 5 silver and 2 gold. We are old and we make too much money for tax credits, making our monthly premiums rather expensive, like in the $1,000s. I left the Obamacare website feeling despondent. 

On the way over to the garden I caught a local NPR talk show that was covering this very subject. The expert confirmed my worse fears, but also corrected some of my misconceptions. She explained that all of the sabotage that Trump, et. al. has been committing this year has caused Saint Louis premiums to jump 50% for next year. Thank you very much, Assholes! She also said that the states have stepped into the void left by the Republicans in Washington. She counseled shopping around. There may be better deals outside the exchanges. I dabbled in this and have been inundated with solicitations since. It feels like the wild west out there. We’ve been on COBRA since I retired. It is expensive too, but it is ending. I knew that this storm was coming. Now it is time to face it. When the going gets tough, the tough go shopping, this time for healthcare insurance. 

The Flu Season Cometh

Stay Protected. Get your Flu Vaccine today!

Flu season is nigh upon us and the Center for Disease Control (CDC) is warning us that this season could be especially virulent. Australia, which is always a day ahead of us, has suffered though a pretty rough flu season over the last few months. Their summer experience has long made for a reliable forecast of our impending winter flu season. The CDC recommends that everyone (6 months and older) get their flu shot this month, before the flu season ramps up. This year’s trivalent influenza vaccine contains Michigan, Hong Kong and Brisbane strains of the virus, making for a truly international cocktail. Patients presenting flu-like symptoms have already reported in most states.  If you have health insurance, vaccination is free. If you don’t, it is still inexpensive and getting one would likely save you money in the long run. Anne and I both got ours as walk-ups through the local grocery’s pharmacy. 

The excuse, “I don’t need a vaccine, because I never get the flu”, does not wash anymore. Your immune system may be strong enough that you rarely get the flu and when you do succumb, your symptoms are mild enough to be dismissed as just a cold, but that does not mean that you never get the flu. Uninoculated you are a menace to society, acting as a vector to spread disease and endangering the lives of the elderly, very young and other citizens with less robust immune systems than yourself. Anti-vaxxers have long decried that no vaccine is 100% effective, but it has been proven time and time again that a comprehensive vaccination program does prevent disease and saves people’s lives. Do the right thing, if not for yourself, then for those around you. Don’t be a baby, do your civic duty and go get your shot. You’ll feel better about yourself afterwards.