Medicare Madness

medicareI believe I have found the explanation for forgetfulness in our aging population.

Medicare.

Like most people, I didn’t give a flip about understanding Medicare and thought old people were just being senile by not understanding it. After all, it’s just insurance. How difficult can it be?

Now I’m suffering from Medicare induced dementia myself.

I had occasion to try and bone up and get an idea of what is going on with Medicare — not that I will ever turn 65 myself, of course. I have never seen such a confusing way to get insurance in my entire life.

First of all, I was under the impression that Medicare and Social Security sort of came together since both are administered by Social Security. Wrong! We are talking about the government here. Everything must be as confusing as possible.

You reach Medicare age at 65. You reach full retirement age for Social Security at various ages, depending on when you were born. It becomes a bit older for each  generation.

Of course, you can retire as early as 62, with reduced Social Security benefits, but the amount you can earn by working after retirement is limited. At full retirement age, you can receive Social Security and also earn as much as you want, presuming you want to work instead of rock.

Before we become totally confused, lets talk about Medicare benefits.

Medicare has many parts and each part covers something different. The parts are creatively named A, B, C, and D. A is hospitalization, B is medical and doctors, D is drug coverage. C once was Medicare Choice (C, get it?), but is now called Medicare Advantage (still C, or MA) C is optional private insurance instead of the original government Medicare plan.

Simple? Good, lets move on. If you have A and B, there are large deductibles, and you need yet another plan to fill these gaps. This is imaginatively called a “Medigap” plan or “Medicare Supplement” (not part G). Actually, these plans might as well be called Greek since nobody is exactly sure what they cover.

Part C sometimes includes D and Medigap but not always. Plans vary greatly, so you have to be sure to find a plan that covers your needs. If you are not retiring when you reach 65, you need A but not B until you stop working, provided you have employee insurance. If you have either A or B, D is optional. A is free for most people, but the rest of the alphabet has a premium attached.

Seniors age 65 are informed that they must decide NOW as the premiums will increase if they wait. They are bombarded with information, mail falling out of the box, and a phone ringing off the hook. Various insurance companies, including AARP, all claim to have the best plan, most popular plan, or a number of different plans to fit your budget. No wonder people are confused!

One insurance plan runs commercials on TV showing seniors dancing and claims to have everything covered, even extras that are not covered under other plans, such as eyeglasses. Maybe extras should be called part E? Soon we will have so many parts we will run out of alphabet and need to use the Greek letters. It is like naming hurricanes.

We have merely scratched the surface of an explanation here. Suffice it to say that if you do not have to figure this mess out for your job, aging parents, or yourself — enjoy your liberty. One of these days, time will catch up with all of us. Of course, there is probably no need to worry about it now as it will be completely different by the time you reach retirement age anyhow.

As I said before, it isn’t dementia that is driving seniors over the edge — it’s Medicare.

Copyright 2007 Sheila Moss

About Sheila Moss

My stories are about daily life and the funny things that happen to all of us. My columns have been published in numerous newspapers, magazines, anthologies, and websites.
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8 Responses to Medicare Madness

  1. Have medicare and supplemental and is OK. However. they take out from my monthly check part D for drugs and still have to pay for a part D drug plan. Seems like I am paying twice.

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  2. Sheila Moss says:

    Not quite sure what you are saying. Government Medicare does not have a drug plan. Many Medicare Advantage plans do. If you have drug coverage under your private plan, either an Advantage plan or the Supplement, you do not need to have part D. If you have double coverage, you should file with both. Typically, the drug store files with the primary carrier and it is up to you to file with the other one for your out-of-pocket charges. I also have two and wait till the end of the year to file with the second carrier to recover whatever the other plan did not pay. It can be hundreds of dollars.

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  3. Sharon Dillon says:

    So true. Dr sends me to another dr for evaluation and I don’t know if that will be paid, or if I even need it. I think some referrals are the the “good ol’ doctors” gang.
    Anyway, so glad to be back on line and catching up with friends. Hope all is well with you.

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  4. You have barely touched the surface of this iceberg! At the ‘young’ age of 60 I was forced into the Medicare world to manage healthcare for my mom. Now, I have been forced to enroll in Medicare Part-A (under threat of death by increased penalties later) as I am perilously close to 65. Here are a few more factors that could add more fun to this maze:

    a) you are still working and covered by employer provided health insurance
    b) you are ‘poor’ and you fall into Medicaid (as opposed to Medicare) which in turn is administered by State agencies on behalf of the federal government

    In a way, Medicare/Medicaid is the strongest motivator to keeping good health – you don’t want to risk falling sick and finding out some additional/ new rules!

    Liked by 1 person

    • Sheila Moss says:

      You are so right. I have never had to deal with Medicaid, but I have heard it is quite a mess. I have not tried an Advantage Plan either. I figured I wouldn’t know if it was better unless I had a basis for comparison.

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  5. The development and expansion of radical new treatments and technologies, such as the open heart surgery facility and the cardiac intensive care unit, are directly attributable to Medicare and the new ability of seniors to pay for treatment. Informative post!!

    Liked by 1 person

    • Sheila Moss says:

      What worries me is that Medicare pays only a fraction of what is billed. Health providers have contracts and have to accept it as payment. I’m thinking that Medicare for all could put doctors and providers out of business. Hope I’m wrong because health care is in a mess.

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