I posted yesterday about getting my Medicare card. That was just the beginning of the Medicare saga. For several weeks after receiving the card, I received mail, lots of mail, about how Medicare works. The most helpful items were a couple of booklets produced by the Department of Health & Human Services. One was called “Welcome to Medicare” and the other was called “Choosing a Medigap Policy.”
The Medicare booklet started with the ABCs, literally. Part A is hospital insurance, enrollment is automatic when you become eligible, and there is no cost to the insured. So far, so good. Part B is medical insurance, and there is a monthly premium for this coverage. It’s optional, sort of. If you choose not to have Part B and decide later you want it, it will cost you a 10% penalty for each year you weren’t covered, and the penalty will apply for as long as you have the coverage – unless you or somebody you know had coverage through an employer or TRICARE during that period, the period when you weren’t covered, by Plan B. Okay, got it. OR you can choose Part C, also known as an Advantage Plan. Some types of Advantage Plans are HMOs, PPOs, PFFSs, SNP, and MSAs, but all types of plans may not be available in all areas. The plans include Parts A and B and sometimes Part D. Part D is prescription drug coverage. It’s optional in the same way Part B is optional. You can opt out, but if you decide to enroll later, you will be charged a late enrollment penalty for the rest of your life. Simple enough, right?
There wasn’t a lot of information about specific coverage. There was one chart in the “Medicare Basics” section that highlighted a few general areas that are covered and referred you to a “Medicare & You” handbook for details. I’m still waiting for my handbook. On the back page titled “Get Your Medicare Questions Answered,” there was a list of websites and phone numbers. Maybe it’s just me, but the websites didn’t seem very user friendly, and the phone numbers were answered by automatons, so I moved on to the Medigap booklet.
If you like word jumbles and cryptograms, this booklet is for you. It was like swimming through a bowl of alphabet soup. Medigap or supplement policies are available in Plan F, G, K, L M, and N. Plans D and G effective on or after June 1, 2010, have different benefits than D or G Plans bought before that date. Plans E, H, I, and J are no longer sold, but if you already have one, you can keep it. Not all types of Medigap policies may be available in your state.
Totally confused, I put the books away and asked friends what plans they had. Friends in Florida and Louisiana leaned toward the Advantage plan because it was inexpensive and comprehensive in its coverage. Not so in Texas or at least in Rains County. It was inexpensive enough, but the coverage was lacking. The network doctors, especially the specialists, were not nearby, and the co-pays for the specialty tests I have occasionally were high enough to offset the savings. I finally chose Plan F. It has no deductible and no co-pay, and it’s affordable, for now.
While I was doing all this research, David took the simple route and signed me up on one of those on-line sites that offers Medicare information. The e-mails and the phone calls started immediately. Armed with just enough information to be dangerous, I talked to an overwhelming number of people, some of whom knew less about the options than I did once we got beyond their ten-question script. I took copious notes and learned what questions to ask beyond how much the premium would be: Will I have an agent or an 800 number? What method does your company use to determine rates? How much will my premium go up each year? Is your company rated? Do you charge an application fee? My confusion cleared a little bit, and the deadline was getting closer, so I said eeny-meeny-miney-mo and chose the company whose rep was the easiest to reach and who gave me the clearest answers.
Now, in addition to my Medicare card, I’m the proud owner of a Plan F card and a Part D card. I’m not sure if I made the right choices, but I guess I’ll find out when I go to the doctor or refill my prescriptions. If I decide I need to make changes, there is an open enrollment period toward the end of each year when I can go through this whole process again. Lucky me!!