Trying to figure out the differences between Medicare plans and determining which one might be right for you is where the mystery deepens.
When I turned 65 and the government asked me what kind of medical coverage I wanted, I sensed a mystery coming on. I learned my ABCs at an early age, and I’m guessing my mastery of these fundamentals reached its zenith in kindergarten.
If only the Medicare people had asked me at the time what I wanted to sign up for in 60 years. I was plenty sharp when I was 6 and could tell you right away how to sort out your letters. Now I wasn’t so sure.
I don’t blame the government for this. It’s doing its part, and I’m grateful for the health coverage. It’s all the other suspects that are making me wonder what to do.
About six months before you become eligible for Medicare, you start to pop up on the radar of a lot of people, and not one of them is a doctor. You begin to get glossy full-color brochures in the mail that show happy retired couples laughing along with the wonders of life. Inside, you find the details on how to order alphabet soup. The first two letters are easy to understand. A is for Medicare hospital coverage and B covers doctor visits.
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You might think that would cover it. And I’m guessing that’s what the original authors of Medicare had in mind. Maybe life really was simpler in some ways back in the 1960s, when Medicare came into existence.
But as time passed, things started to get complicated. These days, the letter C is for something called Medicare Advantage, which is not offered by the government. This is where the private insurance companies fit in. I feel for the insurance agents who call your house with a hopeful tone of voice, trying to get you signed up for a Medicare Advantage plan.
One of my basic rules in life is to never buy anything over the phone, but I try to be polite with these kids. They’re just trying to make a living, after all. And to be fair, these plans are not necessarily a bad deal. I did sign up for one when the dust settled. And one of the reasons is that original Medicare doesn’t cover prescription medications. For that, you need part D, which is bundled in with most Medicare Advantage plans. You only need to get burned one time on an expensive prescription that isn’t covered by insurance to know that you need that part D. I pray every time I walk past the pharmacy inside my local grocery store, thanking God that I’m not standing in that long line.
There is also something called an out-of-pocket maximum, or OOPs, as I like to think of it. With original Medicare, you can still go broke if you get hit with a serious illness. That’s where the OOPs comes in. It puts a cap on how much you have to pay each year for medical expenses. I think you’ve got to have this, even if you are healthy now. You just never know, right?
After your ABCs there follows a bewildering list of coverage options that stretches all the way to G or H, if you can make it that far. Trying to figure out the differences between these plans and determine which one might be right for you is where the mystery deepens. Watson, get me my magnifying glass!
Of course, all this comes at the same time you are really making an effort to stay on the ball, wrestling with the daily jumble or the crossword puzzle in the paper and watching “Jeopardy!” every night at dinner time. Fumbling around with the buzzer is understandable when you’re 65, but don’t get your Medicare letters confused. There’s a proper order to things, and you already know what it is. Start with A.