Well it's finally time to sign my gf up for Medicare. I've been looking forward to this. I'm told it's much simpler and way better than regular health insurance. She can see any doctor, 24 hours a day, no restrictions. Everything's more or less free and she'll be set for the rest of her life. I just need to research it...
3 days, 27 cups of coffee and two 6 packs later...
Ok, Let's see.
- It's not free, there's a $148/month charge.
- There's a $1400 deductible every time you go into hospital and if you stay too long they charge you more.
- $200 deductible for healthcare coverage.
- 20% coinsurance
- Part B extortianate excess charges.
- No annual limit on out of pocket, but at least once you've exhausted your life savings and are too sick to work you can get help paying the costs.
That's OK though you can buy another insurance plan that covers all the deficiencies of Medicare and then you'll be completely covered! There are lots of plans to choose from - Plan A, Plan B, Plan C discontinued, Plan D, something, something, discontinued, Plan G both expensive and cheapskate versions, Plan 9 from outer space Plan K, Plan L, Plan M, Plan N. All with multiple providers charging different amounts for the exact same coverage. Also, the provider can increase the cost of the plan every year but if you choose the wrong plan - tough - because outside of the 6 month window you can't switch because we don’t want people like you on our plan of medical underwriting.
But at least everything's covered. EXCEPT PRESCRIPTION DRUGS!!! Oh and you still have to pay a $200 deductible.
Don't worry though you can buy a 3rd insurance plan to make up for the deficiencies of the two insurance plans you already have.
This will completely cover all your prescriptions. There are lots of plans to choose from and they all cover different drugs and charge different amounts for each one. That's great there are 17 plans to choose from in my area and let's see - only one of them covers both of her insulin prescriptions and it just happens to be the most expensive one. Also the prescription costs increase after 6 months because of - donut hole (??).
Well at least after spending $5-6,000/yr she'll be completely covered except for.
- $200 deductible
- Potentially unlimited drug costs
- No Vision
- No Dental
Fortunately, you can choose a Medicare Advantage plan instead. That must be better right because it has the word "advantage" right there in the name and that's a good thing, right? Well...
- Can't choose any doctor
- $50 to see a specialist
- $375 a day for hospital visits
- $30 for lab tests
- $50 X-rays
- $90 emergency visit
- $30 urgent care
- $250 ambulance ride
- $40 physical therapy
- $6,700 out of pocket - excluding drug charges
- Once you check into Medicare Advantage you can never leave because medical underwriting
But at least you have minimal vision and dental coverage and of the 27 plans available - 3 of them cover her insulin - also donut hole!!
OK seriously though guys, why would anyone think Medicare is good value! Right now she has an ACA plan that has a $0/month premium and a $200 annual out of pocket cost. $6,000/yr seems like a lot to pay to be able to choose your own doctor.
Also, I feel that I have fairly good math and comprehension skills but I'm having a hard time deciding on what the best option for her is. How does the average person understand any of this and make informed choices, especially at the time of life when their mental faculties are starting to decline? It seems like the whole thing is deliberately designed with lots of gotchas. We know people that signed up for regular Medicare only, because the deductibles, copays and coinsurances seemed reasonable, and then got hit with quite large costs because of multiple hospital visits. Fortunately they were wealthy enough for it to not affect them too badly but for the average person living on Social Security it would be devastating.
Note: I did exaggerate a bit here. New York, where we live, does not allow Plan B Excess Charges, nor does it allow medical underwriting and is community rated - so at least she can switch back and forth between Medigap plans and Medicare Advantage if necessary.