Wednesday, October 21, 2015

2016: Surgery Year?

As all of you our there "of a certain age" are aware, this is Medicare plan sign up time. There are ads all over the TV, flyers dropped through the mail slot, even a letter from the agent we used last year.

We called her. We wanted something different, something that would actually follow us around the country, rather than something that claimed to be good in an emergency and when the paperwork showed up later revealed that their brand of coverage was to deny everything.

I'd call that fraud. It may not be technically that, since I'm not that versed in the legalities, but we decided we really really wanted something different for the upcoming year.

The agent promised to check through the plans she had and find some way or another to get a plan that followed us. Maybe there was one where we could just call them and "relocate" for three months. Or something.

We had her over Monday. We've both now switched both plan types and company. Blue Cross is getting our business next year. And I've decided to sign up for what my folks had, which I happen to know about from doing the finances for them to varying degrees for several years. They used to call it "Medigap" insurance. Now they gave it a new name, calling it a Medicare Supplement plan. (Steve opted for the "Advantage" plan instead: less out-of-pocket up front.)

At any rate, regular Medicare is the first line of defense, and it follows us everywhere, with no referrals required, no pre-approval needed for a procedure, no system of doctors you have to stay within, no co-pay needed to walk in the door and over quadruple the fee if it's a specialist. Then the other, the one you pay an up front monthly bill for, covers all the rest. There's still a Part D plan to get, which covers all but a minimum for medications, but for now at least that's fairly minimal.

Our agent suggested that this year would be a good year to get my knees replaced. I'd been told years ago that this would be necessary, but put it off because of the 20% I'd need to cover for the hospitalizations. We're still waiting to see if cardiac surgery will be needed, but the doctor is optimistic that the new medication will remove that need.  Personally, I'm not so optimistic. Six months is about the time after which each of the previous two new meds failed to work perfectly, and in fact began to work progressively more imperfectly as time passed. (I have sporadically wondered if the body adjusts to those medications the way it will to painkillers, where they become progressively less effective until the only thing worse becomes none at all.) If that happens with this one, I'll schedule that surgery next year as well.

Heck, if I like, on the new insurance, I could even schedule it in Minnesota if I wanted. I really liked that cardiologist. Now, though, I need to track down a good orthopedic surgeon and start making appointments.

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