The Nightmare Before Sixty-Five (Medicare)

 Back in September I said I was going to write a big post about enrolling in Medicare (which is handled by the social security administration).

 I am not.

 

Please go out an buy “Medicare for Dummies” shortly after you turn SIXTY-FOUR and start reading.  Prepare to become angry.

 The Medicare system is FUBAR.  And they add new FUBAR yearly. 

 Let me roll over a few points you need to know…

 ~ First, if you are late enrolling you WILL be penalized when you do enroll.  And every month for the rest of you life.  I am not kidding.

 ~ Next, you need to be enrolled BEFORE your birth  month for smooth-ish transfer from private health care insurance to supplemental.  A lot of healthcare insurance will suspend your coverage on the first day of your birth month if you don’t have you Medicare card info.  Once you get the card the supplemental will kick back in.

 ~ Regarding Medicare you have 3 choices:  Part A only (“hospital” insurance – covers hospital and nursing NOT doctors)  OR you can do part A & Part B (covers docs, tests, medical & surgical services, and more)  OR  Part C (aka Medicare Advantage which is private coverage)

 Be aware that private insurance is year to year and they can leave the program anytime- leaving you scrambling to find new coverage.

Also be aware that you might lose your entire health care team.  If your current doesn't except Medicare, you'll have to find someone new.  And that sucks.

 ~ Part D which is optional, covers prescription drugs.  I cannot believe this is legal.  Here is how it works.  You have to pick a private insurance out of multiple “plans” that each pay differently.  The plan goes yearly so the below stuff happens EVERY. SINGLE. YEAR.  Coverage is in “phases” over a year time.

 Phase 1:  You pay 100% of drug cost UNTIL you reach deductible limit (in 2020 that was $435).

Phase 2:  You have a co-pay set by the insurance company.  This happens until you hit your ‘limit’ of $4020 (in 2020).

Phase 3:  So cutely known as “the donut hole”.  The company doesn’t have to pay SQUAT!!!  But you still have to pay them.  You have to beg for discounts and government aid.  You don’t get out of this blackhole until you have spent (in 2020) $6350!!!!!!!!!!  This is where you hear of elders and the sick having to chose between their drugs (often rationing them) and their utility bills and/or food and/or gas for their car.

Phase 4:  (If you make it this far).  You pay 5% to a limit of $9038.

Wrap your head around that.

That is just a few bits of BS (and among the worst) you will encounter in you 64^th year of life.

 

Do not make the mistake of following the advice of family & friends.  Tho well meaning, every person’s situation is different.  Read “Medicare for dummies” for knowledge and deal with the Social Security office ONLY for what is really going to happen.  BTW, a phone call to the SS office is a LONG time on hold.  A speaker phone is a blessing.  My last hold time was 43 minutes.

 Good luck.