The Medicare morass

Posted: June 21, 2022 by chrisharper in Uncategorized
Tags: ,

By Christopher Harper

As I head toward retirement at the end of the month, my wife and I have had to delve into the Medicare morass.

Simply put, Medicare is one of the most confusing bureaucracies I’ve ever dealt with. Since I used to report on government bureaucracies, I thought I would have some expertise in cutting through the weeds.

For the most part, I was wrong.

For those who have yet to head into the Medicare morass, I pity you. For those who have managed to get through the barriers already, I applaud you and also pity you.

Medicare, run by the Social Security Administration, is one of the most complex organizations in the country, providing some form of hospital, medical, and drug coverage for millions of Americans, most of whom are 65 and older.

Here’s my story of banging my head against the Medicare walls.

I wanted to sign up for Medicare coverage a few months before I retired, and that’s tricky. I was able to sign up for Medicare, but I couldn’t tailor our coverage until one month before I retired.

That’s when the voluminous number of letters and responses started with Medicare. It appears that the organization doesn’t know how to use email or other forms of electronic correspondence.

I had to file three separate letters to Medicare to convince the minions that I was retiring.

I then was told my Medicare costs would be significantly higher for my wife and me because I earned more than I should in 2020. I had to appeal that decision, convincing the authorities that my retirement in June would mean I wouldn’t make as much money. That took two appeals—another set of letters and responses—until I finally returned to the original Medicare cost.

Then I decided to obtain a Medicare Advantage program from a private insurance company to ensure my wife and I got decent coverage for health issues and drugs. It’s rather strange since we don’t have many health issues.

The number of Medicare Advantage programs is voluminous and complicated. I still don’t truly understand the drug formula, known as the “donut,”—which is supposed to make it less costly the more drugs you have to use.

Most of my doctors take Medicare, but my chiropractor doesn’t. He finds it too costly to get paid by the government.

Our dentist doesn’t take Medicare. In fact, only a handful of dentists in our area take Medicare, so we added an extra dental plan at $109 a month.

For the past decade, I have had a Health Savings Account, which allowed us to save about 25 percent in taxes on the money spent for copays and other approved procedures that insurance plans didn’t cover. That saved us about $600 a year in taxes.

Medicare doesn’t allow such accounts. Although Congress has tried to pass such measures, not much has happened.

During the 2020 campaign, most Democrats called for “Medicare for All,” meaning that everyone would be brought under the umbrella of the health program. Since it’s estimated that Medicare may go bankrupt in a few years on its present course, it seems evident to me that would be a bad idea.

I’ll report later whether Medicare works for my wife and me. But I’ve added a few more gray hairs and seen my blood pressure rise during my lengthy attempt just to get signed up for the program.

  1. Pod Hamp says:

    When my wife and I turned 65 we were concerned about the transition to Medicare as well. I was sort of dreading the changeover from my former insurance, which we had for about the last 30 years of so. But for us the transition has been pretty seamless so far. Before Medicare I had a high deductible plan with HSA. After I signed up for Medicare, that plan was converted to my supplemental insurance and the HSA was replaced by an HRA (Health Reimbursement Account?) So far I haven’t paid a penny out of pocket for any medical costs other than prescription drugs, and my accumulated HSA saving account get used for that. My wife and I are both former Feds and had a good plan that we were both able to keep as supplemental insurance. Easy Peasey. YMMV.

  2. Bill Heffner says:

    You can contact a Health Insurance agent who specializes in Medicare and he/she will sort through the various supplemental plans and advise you on the best plan for you. It costs you nothing, as she receives a flat fee from the insurer, and since it is the same fee from all insurers the agent has nothing to gain by selecting one company over another. He/she selects the plan that is best for you.

    Mecicare Advantage Plans, which replace rather than supplement Medicare, are not to your advantage, as they severely limit which facilities and doctors you can use. Sign up for Medicare, a supplemental plan, and a drug plan. My wife and I found the initial process a little complex, but only a little, and since then have been more than satisfied.