Medicare

November 24, 2016

 

OK, I'm not stupid. At least, I don't think I'm stupid. I turn 65 in January and it's time for me to register for Medicare. If any of you wish to send me a birthday present, please leave a comment and I'll send you my address. Please keep in mind that I like bourbon, Cuban cigars and really expensive fly fishing reels that won't help you catch more fish but they look awesome. Now, back to Medicare. Trying to figure out how Medicare works and how much it costs has convinced me that I really am stupid.

 

I began looking at Medicare a few weeks ago and thought, how difficult can it be, right? With Obamacare, everything should be simple and easy. Better coverage, lower cost, choose your own doctor and lower out-of-pocket expenses. This is going to be great.

 

Before I get into Medicare, let me explain what I have now and what it costs. I have an HMO plan with my ex-wife as the primary subscriber. I pay about $350 a month and it covers everything. I mean just about everything. I pay a small co-pay to see a doctor and my most expensive prescription costs me $45. The retail price on that prescription alone is over $1,200 a month. Good deal for me. Fine, now I want to replace this private insurance with Medicare and have at least similar coverage.

 

I've been looking at this for weeks and I am still not sure what the hell I'm buying. Medicare is divided into multiple parts: Part A for hospitals, Part B for doctors, Part C which is private insurance that cooperates with Medicare and Part D which is prescription drug coverage. So far, so good.

 

Part A is free since I've actually been paying for it all of my life. Part B is about $120 month, not too bad, except that's not what I'm going to pay. Part B is adjusted according to your income and, with my income, my premium will actually be almost $400 a month. That's about $600 more a year than I'm paying now and I don't have prescription drug coverage or calculated my out-of-pocket which I'll get to in a minute.

 

Now is when it gets funky and I'm probably not going to explain this properly. Bear with me and I'll try to get through it without a glass of wine. Part C is when you can get private insurance, most likely through an HMO that bills Medicare for the basic stuff and then covers you for things that aren't included in Medicare. Good deal?

 

Not for me. HMOs are local and I split my time between Florida and Massachusetts. If I buy a plan in Florida, it doesn't cover me in Massachusetts and vice versa. Not so good. Regular Medicare covers me everywhere that Medicare is accepted, kind of like VISA. Splitting my time means that a Medicare Advantage Plan (gotta love the name, they're going to give me an advantage!) probably isn't my best solution. Well then, back to regular Medicare.

 

Medicare Part A and B don't cover you completely like my current policy. Hold your horses there, Horatio. You need a “supplemental” policy to cover the stuff that Medicare doesn't cover. OK, I'll bite, how much is that? An AARP plan will cost me about $185.00 a month. I checked with them because they're supposed to like old people like me. I'm now up to about $600 a month instead of $350 and I don't have prescription drug coverage.

 

Let's check out Part D drug coverage shall we? First there are plans labelled A through H and most people go with Plan F which I think means F^%k You. Why do I say this? Because the premiums aren't too bad, about $30 - $50 a month, but we mustn't forget the “doughnut hole”. What's the “doughnut hole” you ask. That's when they give you some coverage, then they stop covering you until you've paid a bunch of money out of your pocket before they start covering you again. How much out-of-pocket? Depends on the plan but somewhere between about $4,000 and $4,000,000 a year. Let's figure I get a decent plan that will cost me about $5,000 a year.

 

So where am I? I have to pay about $400 for Part B, $185 for a supplement, $50 for drugs plus I can expect another $5,000 a year out-of-pocket. All together, it's over $12,000 a year to replace a great plan that now costs me $4,200. WHAT???

 

Thank you Washington for the “Affordable Care Act”. It's certainly going to help me a lot.

 

If anyone can really figure this stuff out, please tell me I'm wrong and what I should do for the best coverage I can get. I plan on being sick a lot. After all, that's the only way I can get back all the money that I've already paid in.

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