Opinion

Rx for confusion: Be careful about Medicare – Neil Offen

I can understand all the trouble the Republicans in Washington are having coming up with a new health-care bill.

Health insurance is so complicated many of us look forward to the day we can get Medicare, the government health insurance plan for those so old, like me, they can’t figure out how to change the greeting on their voice mail. Being able to enroll in Medicare is one of the major benefits of getting older, right after the Early Bird Special.

But enrolling in Medicare, which has many moving parts, isn’t that easy.

Medicare Part A, which is free, is essentially hospital insurance, which means you are insuring the hospital you won’t go there very often. But if you do appear too frequently, you get to buy one operation and get the second one 50 percent off.

Medicare Part B costs money, with your premium set each year by a group of secretive garden gnomes who know the year you were born and if the moon is in the seventh house and Jupiter aligns with Mars. If you enroll in the plan outside that time, you pay a higher premium and are forced to listen to remixed songs of The Carpenters.

Medicare Part B covers certain doctors' services, but generally not the ones you will need. It also covers some outpatient care, mostly when you are an in-patient, and a few medical supplies, but not the Band-Aids you called for when you cut your finger slicing a bagel.

Then there’s Medicare Plan C, which is almost never called Medicare Plan C because that would be too easy. Offered by private insurers, these plans are designed to make up the difference between what Medicare pays and what the federal budget deficit is. They provide Part A and Part B benefits, and a free toaster. Also, usually, they offer Medicare Part D benefits, which is actually prescription drug coverage because it would have been too simple to call it Medicare Plan Rx benefits.

Many different insurance companies offer these plans. Each company says its plan is better than all the other plans. Each company says it will cover more, will cover better, will cover 20 percent of this, 100 percent of that (after the first 35 percent) and 60 percent of the second 25 percent, minus the 18 percent co-pay.

If you’re still with us, then there’s a Medicare Supplement Plan, which is different from an Advantage Plan because it does not include Plan D prescription coverage and doesn’t make you pay co-pays after you meet your deductible, on a date set up by e-Harmony.

Your premium for an advantage plan or a supplement plan will depend on where you live, how old you are, whether you can remember the Lucky Strike cigarette jingle and if you have any previous conditions, such as breathing.

If you get a supplement plan, you then will have to get a separate Part D prescription plan, but there may be none left because you have taken so much time figuring out all the parts of the first part.

Neil Offen can be reached at theneiloffencolumn@yahoo.com. Past columns can be found at www.theneiloffencolumn.wordpress.com.

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