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I’m So Confuuuuuused!

September 9, 2016

Whoever said “Old age is not for sissies” must have been talking about Medicare insurance plans. Well, I’m not old yet, but I’ve spent the better part of three days trying to figure out the hows and whys of this incredibly complex program. I’ve also been to a meeting in which a caseworker explained the basics, and I ended up more confused than ever. Which makes me wonder, if I’m having such a hard time, what must it be like for people who are doing this completely on their own, and perhaps with less understanding of the overall health care system than I have?

I have two full-sized publications about Medicare and how to choose the right plan for the individual. My main concern is, of course, about prescription medications and the outrageous prices I’ve been paying for them, so finding a Part D (drug coverage) plan was of the utmost importance.  The counselor I saw was trying to get me to go with a Medicare Advantage plan which would have covered Part A (hospital) and Part B (doctors and other health services) in addition to Part D…one-stop shopping, as it were.

But as I delved into the meat and potatoes of the thing, I found that I’d be limited in my choices of providers, and with a new psychiatrist who only accepts patients with Original Medicare I couldn’t take a chance on losing out. I can’t find a psychiatrist anywhere in my local area, so I’m going back to the clinic where Dr. Awesomesauce used to work; luckily, I was able to find one who not only takes Medicare and is open to new patients, but I was able to get in as soon as early October.

This is a good thing. I’m still very stable underneath all the sadness, but having lost both my therapist and psych nurse practitioner, I need to be under somebody’s care ASAP. I hope I like him; he’ll never be Dr. A, but maybe he’ll be as good in his own way as Dr. A is in his.

Anyway, after spending an entire afternoon researching the recommended Medicare Advantage plans and finding them wanting, I decided to go with a Part D plan for the time being and keep Original Medicare. Because I qualify for what’s called Extra Help, which is a low-income subsidy, my meds will cost me only about $80 a month, rather than $800. Yippeeee!

I still don’t really know what I’m doing. Nor do I understand why this process has to be so damned complicated. I feel sorry for anyone trying to navigate the system without guidance. Even the (biased) assistance from the Medicare counselor was of some use. But it was my ability to utilize the Internet that got me this far into the maze of programs that make up this vast government entity, and I’m really, really thankful for it. I used to be afraid of it, you know…before I graduated from college, I was required to take a computer course which involved Internet usage, and I was terrified of breaking something or messing up the computer beyond repair. I needn’t have worried, because I’ve owned several computers and haven’t killed one yet.

It remains to be seen how successful I’ve been with enrolling myself in Medicare. I’m just glad I’ll have it on October 1st, as I’ve blown through what little savings I had paying for meds. Whew!




9 Comments leave one →
  1. September 9, 2016 11:13 pm

    My father used to be a pharmacist and he always helped his older patients wade through the mess. I know a lot of senior centers do presentations on the subject. It’s very complicated. Keep in mind looking out for free help at libraries and senior centers for next year when you have to decide again.

    Liked by 3 people

  2. September 10, 2016 12:31 am

    Woo! A step forward is not a step back. {Hugs}

    Liked by 1 person

  3. Just Plain Ol' Vic permalink
    September 10, 2016 3:44 am

    I have a MBA and I feel like a raving idiot when I try to figure out some of my wife’s disability/social security forms and other things related to her mental health.

    Liked by 2 people

  4. September 12, 2016 7:39 pm

    If you still need help, e-mail me. My husband became an expert when I was down sick.

    Liked by 1 person

    • September 12, 2016 9:42 pm

      I think I’ve got it figured out now. I’ll find out in short order anyway, it starts Oct. 1st. 🙂


  5. September 13, 2016 1:28 am

    I wonder if anyone completely understands medicare. Glad you have coverage. I haven’t been on WordPress in quite a while. Look forward to catching up on your posts.

    Liked by 1 person

  6. September 14, 2016 10:18 pm

    Medicare, Medicare Advantage Plans, and private insurance plans are all convoluted nightmares. My husband and I are educated and had to fight to clean up messes of retroactively rejected claims due to the fact that I was concurrently covered under my husband’s policy and a Medicare Advantage plan which had a carve out for those who have coverage through their spouse if their spouse works for a large employer. The carve out was deep into the coverage book. I was PAYING for insurance I couldn’t use! Then my husband’s policy rejected all my claims, then all his claims. “Coordination of Benefits” means give us another excuse to deny your claims. Both policies were Anthem Blue Cross… Ridiculous!

    Liked by 1 person

    • September 14, 2016 11:21 pm

      For once, I’m thankful I don’t have employer-paid health insurance. What a pain in the tush…sorry you’ve had to go through that.

      Liked by 1 person

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