Declined. Again.

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Obviously, I’m frustrated.

First, because I have to spend HOURS on the phone trying to figure this drama out.  Second, because after spending all that time on the phone, the answer remains, “No.”

Under Obamacare, I was able to get medical coverage for the first time since 1992 that I could actually use.  2013, I had skin cancer in my shin, and they covered the cost of that surgery for $8,xxx and my out of pocket payment was $860.  $860 for surgery that saved my leg, if not my life.  Life changing.

I worked a Corporate job with excellent benefits from 1979 thru 2015, however, the coverage I paid for was not always usable by me due to my birth defects.  Rather than play the denial game, I simply lived beneath my means, and paid out of pocket for anything I needed.

I don’t drive a Cadillac or fancy sports car, so I don’t need a fancy medical plan.  However, the simple existence of my birth defects becoming public knowledge in 1992 when my medical records went digital meant that I routinely was denied medical care, and “No.” became the standard response for actually using the insurance that I paid for with each job.

With my departure from Corporate America in 2015, the battle for medical coverage reached new heights as I fought for coverage under COBRA for $644 per month.  And, as Aetna, my new insurer under my employer, decided that “No.” was now its favorite word.

In June 2016, I was finally approved for long term disability (LTD), and a 2-year waiting period to qualify for Medicare was also started.  Seriously.  I’m disabled, but there is zero insurance coverage?  Mind-blowing.

So, I paid my COBRA through December 31, 2017, with the knowledge that the benefits would be exhausted as of February 2018.  I tried to select a policy to cover me for my medical needs, but was told that I could not choose it until I was approved for Medicare, which happened mid-year, AFTER the open enrollment period.

There was no counseling for Medicare coverage, and I had to wing it on my own.  I contacted AARP who sent me to United Health Care (UHC), and they promised to cover me for a Medicare Supplement plan for about $150 a month.  I gave verbal approval to complete the forms they would send me, and they took $150 out of my Social Security Disability Insurance (SSDI) check each month, before I saw a penny.

However, no forms were signed.  Why?  Because, when I got to the question, “If you have COPD, please see question 7.”.  In its pre-qualification forms, UHC then informed me that I did not qualify for a Medicare Supplement as I was under 65 and had COPD.

Did you know that there are two (2) sets of rules for folks to qualify for Medicare?  No?  Well, let me tell you.  The protections that apply for workers who retire at age 65 or above are very different than the guidelines (not protections, but “guidelines”) which apply to disabled people under 65 or their specific age of authorized retirement.

Working since I was 13, I have paid into Social Security EVERY year for 42 years (excluding the year that my employer absconded with my tax and SS payments in 1975).

SSDI Earnings Record life long

It makes me crazy to have paid into my benefits for all these years, dealt with the denial of coverage for many of those years, finally gotten the necessary coverage my payments should have yielded under Obamacare, only to go back to this whack-a-mole game of trying to obtain the disappearing benefits – even when one is required to pay yet again for necessary coverage !

As you can see from my crazy paycheck history, my income changed all the time based on health, what type of job I was working, family issues for changing jobs and relocating, etc., etc., etc.  But every single year – regardless of what was going on it my life – I paid into the program(s) meant to help me if I became disabled or achieved retirement age.

So, it’s maddening to be declared unable to work, and then find out that in addition to the changes that were made to Social Security and Medicare over the years, there was an additional change that prevents someone who is not indigent and not yet of retirement age, to qualify for the necessary medical coverage they need when disabled.

Medigap insurers

Having worked my way through their websites (useless !  one cannot enroll on a website – WTF !?!???) I am at my whits end.

I can see a great policy – if only I were allowed to exercise the right to buy into this supplemental insurance !

Medigap F

Starting with the thought that my premium might be between $21 and $74 each month, imagine my surprise to chase this ever-evading insurance company ball all the way to the point where my costs would be $455.99 per month – if only I didn’t actually NEED my insurance due to my pre-existing condition, COPD.  So, having wasted time attending seminars, combing the website, consulting the professionals, and having spent three (3) hours on hold this morning, going through the phone tree with various companies, I once again confirmed – there will be NO INSURANCE COVERAGE for me due to my pre-existing condition.

It doesn’t matter that I never smoked.

It doesn’t matter that I’ve not been hospitalized since childhood.

It doesn’t matter that I’m not on oxygen.

It just matters that I have a lung disease which MIGHT cost them some money, so I get zero insurance coverage except for what remains of the original Medicare coverage which has been cannibalized within my lifetime to deprive me of benefits originally paid for when I first signed up for coverage in 1974, when I was a child of 13, starting my first job and trying to survive while my parents marriage imploded.

So, with all this under my belt, I’m going away to get my monthly haircut.  I’m out of energy and any semblance of patience for today, so I will be at this keyboard again tomorrow trying to find an insurance company to throw my money at in the hope that any worst-case medical expenses not covered by original Medicare will be picked up by them.  Medicare Allies says they can help.  Let’s hope they are being truthful in my case:

Medicare Allies 2019

Medicare open enrollment is frustrating.

So needlessly exhausting.

We need socialized medicine that doesn’t deny one coverage due to birth defects.  If we are going to insist on keeping these children alive by repairing their birth defects, then we need to have a medical insurance program that ensures that they maintain quality of life without being driven into poverty through covering their medical needs – if they are able to work, or were fortunate enough to be able to work and buy their way into benefits at some point during their lifetime.

Actions have consequences.  If we are going to insist on life at all costs, then we also need to insist on QUALITY of life by allowing those people who have birth defects to protect their assets against raiding.  The stress from trying to juggle all the bills involved in remaining healthy is exhausting, and no one is well enough, in my humble opinion, to want to sign up for this medical denial of coverage dance once a year during open enrollment, or every time they have to use the actual benefits they’ve paid for.

 

 

 

Quincineara beat down

In this generation of #MeToo, I’m watching all the quincineara preparations of the young ladies around me (similar to the debutante ball my Nana tried to get me to desire and agree to have, just before I graduated high school), and it’s just exhausting.

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I am well beyond the age of getting married and having kids, but I’m at the other end of the age scale where an unmarried older woman has no one obliged to take care of her thru means or family or birth, so the focus on a woman’s day as a married princess or object of desire is beating me down and exhausting my psyche.

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My decision was made long ago, in terms of hope, my reality, and knowledge of what I would and would NOT tacitly agree to endure, in order to “hope” for security in my old age.

I say “hope” for security, because the reality that I’ve experienced is that the woman is sold a bill of goods about her value as an untainted virgin, and her family rushes her into marriage (either approving or disapproving of the male) in the hope that any pregnancies happen within the confines of marriage, so that the grand children are someone else’s responsibility to raise.

For all intents and purposes, they bless the union hoping 2 unfinished but physically mature children  will grow old together, learning to cleave to each other, despite life’s storms.

The family hopes for prosperity and joy for the young couple, and they pile on the pressure (with Mother Nature’s full backing and manipulation of the hormones) to hurry up and add kids into the mix.  All while raising the next generation of girls to desire a fantasy as they mature,

While I have no hands-on experience of the debutante ball or quincineara party, having chosen a solo path for myself, I do have opinions on the outcome.  But, there’s no surprise in that, is there ?!???!

We are programmed at a young age to think of things life and our corner of the village or society “owes” us.  Birthday parties.  Christmas presents.  Weddings.  Showers (bridal, birth, new home, etc.).  We are taught (at least in my culture) that life events are a series of routines and obligations.  That you show up for someone, and they show up for someone, and then a combination of friends and family show up for you, “when it’s your turn”.

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(See the people peeking out of the shack in the background?  That may be her reality for living conditions once the sweet 16 ceremony announcing her availability for marriage and motherhood is over).

For some of us, the rules have changed or evolved when we weren’t looking, and we never get “our turn”.  In my case, it was embracing Women’s Lib as a way to have it all and be beholden to none.  After all, I reasoned, my Mom did everything right and still ended up working all hours of the day and night (with the help of her wonderful girlfriends) to keep a roof over our heads, and the plumbing working, and the bills paid.  Mom broke the cycle of silence by opting for divorce vs. accepting disrespect and abuse from her spouse,  and it was her choice to walk away from the insanity of her marriage that was the saving of her and all of our lives.

In my case, the passing of my Mom and Brother informed me over time that my choice to move away from my family, to break with tradition, has left me without a home port.  I became an adult orphan when I moved 3,000 miles away from my home port, and I never knew it because I made a conscious choice to build a husband and child-free life, and I moved into a youth-oriented area full of single people who appeared to have made similar choices.  Plus, my ability to hide from my family’s censure or expectations (if ever necessary) was strengthened by weekly or as necessary phone calls between myself and family and friends, so the bonds stood firm.

It is only when the fabric of our support circle is ripped through the passing of another that we realize how truly connected we were to each other, and how important it is to mend the fabric of our bonds to ensure continuity.  It is only when we see who among our family or childhood friends refuse to meet us half way in rebuilding a bond that we realize what we’ve lost with the passing of a matriarch or sibling.

So, we build again and we hope again, and time passes.  Now, we are the older, single person in a space that appears to only value youth and malleability.

Married friends launch their kids into the world, building the next generation, and the topic of Sweet 16’s, Debutante Balls, or Quincinearas become important to the next generation of Grannies and Nanas and Moms, who see the changes in the world and want to pass on “protection” to the next generation of women by ensuring the girls go down a path of set expectations for “princesses” or “queens” about how a ‘real’ woman lives, the matriarchal center of her family through the ages.

As I get ready to welcome a long term guest into my home, a women with an ex husband, grown children, and few places to turn, I wonder at that mythical young woman making her quincineara.

She’s surrounded by family, friends, momentary party excitement, and a “village” trying to direct her choices.  Trying to ensure that she is married young, before she knows who she is and what she wants from life.  Trying to ensure that she gets pregnant quickly to continue her species, as well as plant the seeds with those much hoped for children for anticipating that they, in turn, will be the extra hands of caring and support that her parents and grandparents may need as the circle of life continues and those hoped-for babies grow to adulthood, and pick up the mantle of caregiving aspirations.

I, meanwhile, deal every day with how best to retain my independence, afford to age in place, and stay as healthy as I can despite my medical issues.  Child free, and without anyone emotionally and biologically programmed to care for me as my body continues to age and my birth defects continue to evolve and plague me.

As I visit “F”, who is coping with dementia, and try and share companionship and adventures, I reflect on her 3 marriages, divorces, and childless state.

As I visit “F”, whose affairs are supposed to be monitored long distance, from Canada, while her mind and personality slowly slips away, I wonder at all the thousands of choices that had to fail to bear fruit for her to be here, at this moment in time, independence gone, and depending on the kindness of strangers as caregivers in her assisted living facility.

I am thankful “F” made good choices that lucked out to her having financial independence until her money runs out (which will hopefully not happen until after her mind is fully gone), and I’m grateful that she has some connections to family in Canada who will handle her affairs to the best of their ability, even though they won’t get on a plane or drive down from Canada to see for themselves that she’s doing ok.

Meanwhile, I’m also opening my home to “CM” who did everything society and her family expected, but..

– who ended up divorced and raising her kids solo

– who had a husband who refused to pay child support

– who now has grown children struggling to build their own lives

– who is now 64, never really worked (beyond raising kids), struggling financially, and

– who has been couch surfing since at least 2009, trying to survive.

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”CM”, if the Park managers agree, will move in with me as we try and get her back on her feet, financially, by helping her qualify for subsidized housing so that her broken and no-longer-able-to-work body can have a place to call her own in order to age in place.

At some point, if she cannot get the help she needs any other way, we may have to force her into a woman’s shelter to allow her to jump the line for necessary housing assistance.  “CM” was supposed to get on various waiting lists way back in 2009, but I suspect that pride and hiding from her reality stopped her from following thru on those recommendations to get what she needed.  At any rate, I’ve agreed to give her 6 months or so in my spare room at Old People’s “Camp”, and we’ll see what’s possible for helping her avoid homelessness.

She’s a far cry from the unknown road ahead for that quincineara girl, but in the belief that it truly takes a village to help each other get thru each stage of their lives,    I’ll try my best to help her get on her feet and stay independent for as long as possible.

It what the village is supposed to do, when one of their own needs help.

 

 

Elder Abuse

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Today, I was supposed to go help my friend, F, reorganize her single large closet in her assisted living apartment.

We were going to sort through all the clothes she moved from her home, weeding out the ones she no longer wears or needs, and organizing her travel photo albums so that they would be on bookcases at floor level, instead of higher up on shelves in the closet where she can’t access their contents.

We were going to move the chest taking up space in her bedroom, blocking easy access to the closet, and we were going to find a way to store her granny cart and her vacuum so that they weren’t taking up valuable floor space outside her closet.

Instead, I’m going to be dealing with a panic attack over finances and trying to calm her down.

P, the controlling friend that has made all the decisions regarding F’s finances, is harping on the fact that F is spending “too much”, all while knowing she just sold her fully paid for home for $789k, and that the place F has chosen to live should run her about $70k to $80k per year.

Instead of treating F like an impaired but reasonable adult, P is refusing to answer F’s questions (regardless of how many times the questions are repeated), leaving F to play a tit-for-tat game of hiding her money (and pulling out a lot of cash so that she feels she has control of her money, since she’s no longer seeing monthly statements).

F’s determination to wrest control from the largely silent Canadian relatives who have all her money and power of attorney (now that she’s been declared in need of guardianship / conservatorship) is a drama that didn’t need to be.

But, I blame P as the instigator.

P is a control freak, in my humble opinion, and her unwillingness to answer F’s reasonable questions has lead directly to this crisis.

(Calling me last night about 8:30pm to cancel our get together today, and then calling me at 6:02am in a panic to discuss things, shows what stress F is being put under by receiving mixed messages and different answers from everyone in her life).

So, I’ll go see F later today as originally agreed.  We’ll work out a strategy for her to stay calm and – possibly? – get some answers.  And, I’ll give her some suggestions about how to stay calm and create a workable budget for weekly cash so that she has a negotiation strategy for dealing with the drama that I otherwise consider elder abuse.

Please, if you have an elderly friend whose elevator no longer goes consistently to the top floor…  just be kind.  Be patient.  Answer all their questions even if they’ve asked them 1,000 times.  Don’t bully them.  Don’t boss them.  Try to listen and be supportive without badmouthing anyone else trying to help them.  Just care enough to show up.

We’re all going to be in a vulnerable point at some stage of our life due to age, infirmity or financial vulnerability.  Just be patient.  Try your best to be kind and not make the situation worse.

 

 

The Buddy System

 

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Since I’ve been back from vacation, Herself has taking to cuddling more than ever with me.

While she was grooming me and patting my hair before I left, now she’s cuddling up with me and laying her paws along my neck, which turns out to be a very comforting gesture for both of us.

 

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My very good friend and former boss, F, lost her mind in the 3 weeks or so that we were out of contact.  I came home from vacation to find her phone disconnected, and a variety of packing boxes and kitty litter boxes on the patio when I stopped by to see what was happening.  Very disturbing.

Since then, I’ve found that she was conserved against her will and for her own safety due to increased dementia or Alzheimers issues.

While this is good in many ways, ending the whole, “How do you know?” debate over when to act and when someone is safe to leave alone, I’m really struggling with the fact that F, my former boss and mentor and friend since 1988 is being disrespected as part of being conserved.

Having tried unsuccessfully to get Las Vegas Auntie the help she needs while working through the system, I can’t say what’s being done to aid F is the best way to handle things, but I can also say that she does need assistance (and supervision, when she’s hit a dead zone in her brain and is speaking nonsense), but that I’m frustrated on her behalf because she’s not being included (no matter how frustrating it may be) on things which will impact her quality of life.

In my oh-so-humble opinion.

F picked the Memory Care / Senior Assisted Living Center where she’s been moved.  The problem is that she picked it across the street from her senior center so that she could continue to go to classes and events there, and she is now no longer able to go without company or supervision.  She’s been artificially restrained to the grounds of her care home unless someone signs her out, and that seems too harsh to me.

Don’t get me wrong – her private, 1 bedroom apartment is very spacious, and sunny, and they permitted her to bring her 3 cats, so her personal comfort has been given a great deal of thought:

 

 

So, things are not as dire as they could be, and she seems relatively happy.

F has always been a walker and a biker, and at 82 was still driving well despite her memory issues.

Now, all of that is gone.

So, I stopped by again yesterday to take her to breakfast – we were walking the .08 miles each way – both to give her an outlet, as well as give me some much needed exercise.

The day went well, and she asked me if I’d drive her to Costco to pick up her contact lenses after breakfast (she hasn’t had any in almost 2 weeks, making it hard for her to see in detail), and also asked if I’d stop by her home to see what’s happening since P, the friend who is handling most details, isn’t keeping her informed.

Not a problem, as long as my energy lasts.  NOTE:  I live in the boonies, so every day in life now involves counting my spoons of energy, and making sure that I stop before I’m tired so that I have enough energy left to make the 45 minutes (or longer) drive home.

Second side note:  F was an incredible boss and mentor.  Always polished.  Always organized.  We used to have an ongoing joke among her direct reports that we’d get “frantic-grams” during any involved project that wasn‘t moving fast enough for her sense of necessary timing for accomplishing or completing a task.

F was worried about her stuff – (even though she’d agreed that the stuff left behind was to be sold to help her raise some much needed money) – and she was frustrated about how slowly the workers were moving, dragging out the time involved in getting her home ready for sale.

So, I agreed to take her on both errands, knowing that I had signed her out until Noon and had to have her checked back in by that time, or I’d be getting a call.

Upon arrival, F was concerned her patio gate wasn’t locked.  She was upset that she found a box of Fenton  glass collectible shoes outside.  Ditto her doll chairs, where her teddy bears used to reside.

 

 

[P, the person stepping up to handle F’s affairs, is excluding Fran from progress updates, leading to F’s level of upset from not being kept in the loop].

So, we went through the house and she found all of her dirty laundry had been left behind, along with a few family pictures that would be of interest to no one else.

We also found 12 pair of contact lenses left behind, so that eliminated our need to go to Costco, as my energy was running down.

After packing F, the laundry and the family pictures up, we left her condo and returned to the care home.  No fuss.  No arguing.  Just very matter of fact.

Yes, F was using the wrong words to describe things (I’m in trouble and kept locked up because I “wander”, not because she is a champion “walker”).  Similar words, but with very different impact when used improperly.

Also:  Her doctor is an evil man who ordered her confined to her new care home.

Plus:  The police won’t let her leave her care home.

There is nothing keeping F in her new care home beyond the prison of her own mind, and her law-abiding personality for trusting those in authority.  She has a natural respect of those in charge.

F is confused, which is normal for people with dementia, but she’s also cowed (not her original personality), and not at all combative.

IMHO, F should be involved more in having her questions answered and her mind put at ease, but P does not appear to feel that’s reasonable to do.  P does not see the disrespect with which she’s treating F, making her frustration with the process worse.

I have no answers, as I know what happens when one can barely function (like Las Vegas Auntie), and is left alone to play in traffic without consistent adult supervision.

For now, I’m just concentrating on the buddy system for ensuring F gets out and about to enjoy life while leaving the heavier burdens in others hands to address.

Hopefully, things will level out given time.

 

 

Spoons

I can’t tell if I’m lazy or tired.  I can’t tell if I’m the source of the problem, or if forces beyond my control are holding me back and limiting me.

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Every day, it’s a challenge of positive thinking and trying vs. very real exhaustion and pain, plus limited financial resources.

Today’s the day my 2016 taxes were supposed to be done in order to comply with the law and get my refund.

Well, I missed that deadline.  Despite working on my  taxes with great intent since December.

…Is it my old nemesis, Laziness?

…Is it my “You’re not the boss of me!” reactionary thinking?

Today’s spoon theory above is contrasting with the, “Achievers do this” meme, below:

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While I know I’m willing to embrace change and fail in order to make progress in my life, I’m finding I have zip for “staying power”.  While I do accept full responsibility for my behavior, what does that mean in the bigger picture of my exhaustion causing me very real dollars in terms of handling my responsibilities?

No idea at this point, but since I’m sitting here writing a blog instead of getting on with life, I’m voting for some sort of laziness and ennui bolstering my very real exhaustion as demonstrated by the spoon theory / battery life poster:

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When you’re on vacation, there are distractions to keep your adrenaline pumping and driving you to keep up.  At home?  When I’m chilled and trying to find my motivation?  Nope.

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Today has now become a new chance to clean up an old mess or failure.

 

Do they know?

 

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I’ve been trying to figure out a way to say all that’s on my mind, and I’m stumped.  No one wants to be a Debbie Downer, but the passing of others from our lives, regardless of how on the periphery they may have been, is something that should be dignified by others notice.  Others consideration.  Others contemplation of what awaits us all when we finally retire from this mortal plain.

I started the day with a reference to “Cadence” in a beautiful story about Sam in a coffee shop named Cadence.

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Silly me, I had hoped it was about my former employer, a software manufacturer named “Cadence”, and I eagerly looked into the story about Sam, envisioning someone talented working  as part of the kitchen staff of my old employer, now relocated to somewhere in Utah.

Instead, I found some old writings about a coffee shop, located I know not where (yet), and in reading other blogs by the author, Shannon, I read about “George”, a seemingly homeless or very much marginalized man who was struggling with stomache cancer and no meds to help him eat, way back in 2016.

I know it’s silly to want to know what happened to George, as the odds are against him still being around, but these are the things I wonder about.

Yesterday, I went to my Better Breathers Class, and I found that a woman I’d enjoyed meeting with once a month for the last 2-3 years had also passed.  Linda Sloan was quite a character, determined to enjoy life despite her situation, and I heard about her two cats every month.

Now having it confirmed that she had passed, I wondered about the two cats and how they were doing.  I tried to track down her obituary and that of Hiroko, who passed at the end of February.

While Hiroko’s husband and she were mentioned in a Florida obituary from 2006, upon the passing of her father-in-law, there was still no obit for Hiroko.  Her husband had stopped by to let her respiratory specialists know of her passing, but there’s still nothing in the newspapers to alert the wider world of her former chiropractic patients and friends about her passing.

Linda’s obit, unfortunately, was even sadder after I’d found it.

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No mention of friends, family or cats.

I don’t know which is sadder – the news blackout with no obit, or the very plain notice of Linda’s passing, without regard to her origins or any loved ones left behind.

Just a bit melancholy today, despite smiling at George’s dire circumstances and his upbeat outlook on life way back in 2016, “Oh I’ll be alright now!!  Got me some medicine to help me keep my food down!”

Our world is a snapshot of us convincing ourselves everything will be ok.  Regardless of the realities we face, we are resilient in our stubbornness.

 

Burning Bridges

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Medicare as a whole is supposed to be something I paid into during my 42 years of working.

First, they whittled back the benefits to “parts”, then then began limiting what “parts” Medicare would cover.  Currently, Medicare only covers Parts A (hospital) and B (medical services and supplies deemed medically necessary to treat a health condition) insurance.

Because they next spent time limiting what Medicare would cover (only 80% of any approved bill), and how long it would cover you (limiting your days of treatment, regardless of what your medical practitioner says), one then needed to figure out a whole alphabet soup of coverage for things that they won’t cover.

They scare you to death that you’re not going to get your necessary medical care if you don’t have a medi-gap or some sort of secondary to medicare “supplemental” policy.

C – covers at least the same health care services as Original Medicare, but they may also pay for services that are not covered by original medicare such as vision and dental care.  These are called “Medicare Advantage” plans – but, nowhere in the coverage do they inform you that if you have an “Advantage” plan you give up access to your original medicare coverages, AND that the new policy “manages” your care and can say “no” to provision of services even though the Original Medicare allowed full access to the coverage.  Maddening.

D – Medicare Prescription Drug Benefit which is an optional benefit to help you pay for self-administered prescription drugs.  But, fine print! – the cost of most drugs are already supposed to be covered by Original Medicare part B.  Confused yet?

E – To quote the government, “There is no official part E of Medicare, but there is an additional piece that deserves consideration.  The missing link is called Medi-gap insurance or may be referred to as a Medicare Supplement.  This type of insurance is used to provide coverage for some of the things that Original Medicare doesn’t cover such as:  coinsurance, copayments, and deductibles.”  (A pretty good support blanket for a part of Medicare that doesn’t really exist).

F – A Medi-gap plan, or Medicare Supplement, pays after Medicare to help cover your deductibles, copays and coinsurance that you would otherwise be responsible for.  When you add a Medicare Supplement Plan F or E to your Original Medicare benefits, your coverage will be quite comprehensive.  Wait… wasn’t that supposed to be E?  Why do we need an E and an F?

Clear as mud, right?

G – Medicare Supplement (Medi-gap) Plan G may help cover the full cost of out-of-pocket Medicare expenses such as co-payments, coinsurance, and excess charges.

Wait…  I thought E and F took care of all of that.  Are you telling me that F only covers parts of the otherwise not covered expenses?  Seriously?  Why doesn’t F say that clearly?  Why do I need E or F or G or all ????

H – Medicare Supplement Plan H is a lot like plan C.  It covers the basic benefits that include hospital co-insurance, generally the 20%  of outpatient expenses, 365 additional days of hospitalization coverage, and additional blood coverage, but it will NOT cover Medicare Part B deductible.  WTF ?

I – there is no “I” plan or part.

J – it’s a special plan for certain states only to ensure that the excess when you see a provider that does not accept Medicare is paid, after you have been billed $155 of Medicare-approved amounts for covered services.

K – Medi-gap Plan K offers partial coverage for a variety of Original Medicare costs that you’d normally have to pay out of pocket.  This plan covers 50% of the cost for Medicare Part B copayments or coinsurance.  (Thus, reducing your out of pocket from 20% down to 10%.  Got it?).

L – includes a percentage of Medicare Part B expenses as listed, plus supplements Medicare Part A for hospice coinsurance or copayment (generally 20% of the otherwise not covered amounts).

M – generally is a middle of the road medi-gap policy for covering some of the costs that Medicare A and B don’t cover to help you with your out of pocket costs.  But… it’s very unclear as to what percentage of the 20% of uncovered costs or services it will cover.  Surprised?

N – Medicare Supplement Insurance plan which covers 100% of the Medicare Part B coinsurance costs, with the exception being that it requires a $20 co-payment for office visits and $50 for emergency room visits.

************

So, knowing how confusing all this is, and now being informed that my primary care breathing Doc is UNABLE to see me because it’s now ILLEGAL for him to do so when Medicare is my main insurance, I tried to get help from various medicare insurance policies for most of this month to change my supplemental policy (now that I am informed that EVERYONE can change their policy in the first 3 months of any calendar year if they are unhappy with their coverage).

Lots of phone tag, but no real progress.

So, today I bit the bullet and cancelled the Supplement outright knowing that I will be responsible for my medications and 20% of uncovered services.

Yes, I was burning bridges.  But, at a certain point I have zero willingness to figure this mess out.  It’s needlessly confusing, and it’s easier to figure out what drugs I will or will not take based on my out of pocket expenses than it is to figure out how to sign up for the appropriate coverage that won’t limit my choices and won’t make me feel like I’m trying to figure out something as complicated as my taxes (which we already know I procrastinate for completing) every time I have to deal with the coverage allowances.

burning-bridge-light

So, it may be foolish, but the problem is solved for today.