esrosedotblog

MEDICARE BLUES

I was among the 70% of Americans who remain clueless about what and how to go about signing up.

At first, I thought that I would just stay with my Blue Cross supplemental plan which has some drug coverage.

Then, the company itself said that it could not compete with the Medicare funded plans and that I should be signing up with one of them.

I began to read and scan the web and ended up with the medicare.gov web site planner. For awhile, it was not functional but now, it seems to be running well. It took our drug list (formulary) and listed our pharmacies and all.

And showed me almost 80 plans that I could choose from. Each was priced and laid out on total cost per year including premiums and the very strange deductible features of the plan (250 deductible up front and then no payment when I hit 2000 to 3500, then it resumes—the hole in the donut).

Eighty plans.

In parallel, I have been talking to the agent who got us into Blue Cross in the first place. We came cross country and found, contrary to assurances back east, that our insurance plans were not to be honored here. We had to start over. Both of us had a history of major medical expense.

The agent got us into a high-risk pool which is required in California, but did so with some good (relatively) rates.

As it turns out, Blue Cross has a pretty good Medicare D plan (C is the HMO plan, D the stand-alone. We won't do HMOs. Sorry).

It looks like we can get into that plan and stay with our present provider who will continue the non-drug portion of the supplemental.

I am going through this only to make a couple of points. Most people do not even know that there are agents (in some states) who represent the insurance companies. Ours reps Blue Cross, Blue Shield and some others.

Their commissions are paid by the insurance companies. They know the ropes. Cold.

I am pretty sure that this is going to work out for us. It will not be the cheapest plan or the most expensive but it will be workable and comfortable. I know that BC is as consumer friendly as the non-consumer friendly industry can get. And, my agent will help me when and if there is trouble. She walked a friend through a really hard time of cancelled policies and got him reinstated.

We have a lot of time to get the plan in place; May 15. After that it gets more expensive per month. If we can get it going before the end of this month, I will not have two deductible periods. The present plan has its deductible as of the first of the year, so we could get hit twice by making the change.

The whole thing is not as complicated as it seems but it is daunting. A lot of people do not have the 'net skills I do nor the ability to go to a rep. A lot of people are going to have to go through HMO's which are notoriously non-friendly.

I was daunted too, at first. Now there is some progress, I feel better about it.

Oh. Is the Medicare drug plan a good deal? Yes and no. Or, rather, I think so but there is no way to tell. It will be about the same coverage as I have now at about half the price. But there is that hole in the doughnut. As long as we do what we are doing with drugs we are OK. If we get over the 2000 mark, the benefits decline. Until we get catastrophic at 3500, that is. Confused? So are many hundreds of thousands of older people and not all of them non compos mentis.