Thursday, October 24, 2013

Medicare: As "Easy" As A-B-C-D

Hallelujah!  Another perk of being old and decrepit!  And, Medicare isn't part of the Affordable Care Act (so I'm told) so the fact that I'm totally dumb on that subject isn't going to ruin my life (I hope.)  It's all very confusing but I think I've got things straightened out.

I've qualified for Medicare when I became disabled but didn't need it because I was covered on Dave's health insurance from work.  When Dave quit working for Fresno County, we went on COBRA because it was better coverage than his new employer offered.  We were happily on that for three years until we hit the limit and had to go off of COBRA and on to the coverage offered by his current employer.  I decided to take advantage of all the Medicare offerings but was told that since I hadn't taken it three years prior (when we opted to take COBRA) that messed things all up.  My biggest mistake: NOT realizing that COBRA isn't the same as employer offered insurance.  It was the same insurance company, same plan but totally different.  Clear as mud.  I still don't quite get it  but Oh Well.  Here's where the Feds in all their wisdom really showed me how very smart they were.  Follow me here, there is a lesson to be learned:
1.  I paid high premiums for a private insurance instead of paying a lower premium and having the government (aka Medicare) pay all my bills.
2.  During that time I had an accident and racked up about $100,000 in medical bills which were paid for by my private insurance.
3.  Since I hadn't signed up for Medicare which would have allowed them to pay my medical bills they, in all their wisdom penalized me and for ever and ever and ever I will, when I finally do sign up for full Medicare coverage, have to pay a 30% higher premium than if I had signed up prior and let them pay my $100,00 medical bills.
4.  Miss Thomas from Social Security would NOT sign me up for Medicare at that time and didn't really care how I got my medical bills paid.  No matter how much I paid for the premiums they said I wasn't able to get it at that time. 
5.  Fortunately I was able (barely) to still get in on other insurance then. And, even more fortunately, it proved to be very good coverage when I really needed it--this was during my "window washing" episode.  Wheew!
   If any of this makes sense to any of you, you are no longer my friend because I know this is really crazy and I don't want friends who use the same logic as our government.  BUT, the long and short is that NOW that I've served my penance I can once again attempt to sign up for Medicare and I think this time they will welcome me with open arms.  I'm going to get a part C plan which includes A,B and D through a private insurance company that works with Medicare to give even better service than Medicare alone.  Get it?  Don't worry about it if you don't.  Your time will come and you'll eventually catch on.

I had to get this out of my system so don't try to explain it or ask for me to explain it.  The bottom line is that I will be able to get good health coverage through Medicare at a very reasonable cost for the rest of my life or until Medicare runs out of money.  And that is something I refuse to even think about.  What scares me is that I am reasonably intelligent and well educated and a health professional myself having had jobs that deal with this kind of stuff all the time.  If I'm wading in mud up to my pierced ear lobes, how about people without any prior experience?  It is hard to imagine. Hopefully they get to speak with Gwen. 

I was just on the phone with  "Social Security"--somewhere back East and after being on hold for an hour, I had a nice conversation with Gwen and she was very helpful.  I have found that every time (except that problem with Miss Thomas over the COBRA issue two years ago...) I speak to someone from Social Security they are extremely nice and helpful.  I discovered this when I was handling Medicare/MediCal issues for my in-laws.  Once you get past the hour long hold time or the dirty, loud waiting room it's not like dealing with government at all.  I find that so refreshing.  They get bad press, but they have always been kind, patient and helpful when I've dealt with them (maybe Miss Thomas was constipated that day in 2011, I don't know.  I pray she is now flowing freely.)

The funny thing is that for a while Gwen was working on printing some of my information and thought I was on hold.  I heard her chit chatting with her co-workers about this and that.  It was nice.  Way better than the awful music.  She apologized when she came back on the line and found me live.  I told her at least I knew she was still with me and I hadn't gotten cut off.  That would have made me uncontrollably unhappy to have to re-dial again and wait again.   Oh, the humanity.....

So, if you have to find yourself in this position, be not afraid.  If you get Miss Thomas, just ask for Gwen.




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