That Change-Of-Insurance Time of Year Again

Phooey!

I'm so glad I don't have to deal with it. I'm on straight Medicare, plus the additional "Cadillac" supplement plan. It's such a good deal that the government discontinued it, although the plan is grandfathered in for those already on it. Yeah, the price of the latter goes up each year, but it's certainly been giving me my money's worth since I first got it. I get the medical costs summary sheets in the mail. They tell me what kind of unearthly costs I've pulled out of the system since the last letter, what regular Medicare knocked them down to as a permissible charge - which they accept just to get patients and at least some money promptly. Then the forms list how much of that Medicare pays for, which is still just a percentage  of the allowed cost. After that I see what my "Cadillac" plan kicked in. Finally is the best of the news: how little I have to pay myself. Most of the time it's zero.

I've been putting that to damn good use this last year and a half! It reminds me of the year I had three cardiac procedures weeks apart.

On the other hand, Steve puts his faith in his Medicare "Advantage" plan. It covers most things, but it tells you which doctors you can see, which hospitals you have to go to, barring a life-and-death emergency, and follows other stipulations. As a result he's paying off several medical bills for individually agreed upon prices every month. He's had a tough year.

Just to add insult to injury, they sent out the dreaded letter informing him he's going to have to pick a new insurance plan starting in January. He had a better plan the previous year, but that company sent him the dreaded letter as well. We are both used to shopping around for Part D plans, the ones covering medications. It seems each plan covers different percentages of different medications, likely dependent on how the pharmaceutical companies change their prices each year, or what restrictions the governments puts on prices for say, insulin. My letter on Part D changed my cost on several medications next year by small amounts each, from no cost to under $5 each. It will be a nuisance, but not more.  Steve's Part D is included in his "Advantage" plan, and will be what the new company says it is. No separate shopping around, either a benefit or a disadvantage. We'll see.

He got on the phone this afternoon, calling back on one of those flyers getting sent out by alternative companies. Ironically, the company that just kicked him out was among them. Good old left-hand, right-hand, no brain between. Or maybe it's just cheaper to sent one out to EVERYBODY on a large list. 

His call lasted around an hour. They had lots of questions for him, he had lots for them. This time he found out our primary doc isn't on their list of acceptable doctors, what they call "in network". They did have one about a mile closer. I'm keeping the one I have, thank you. I like her for my needs. Even more, I'm willing to sit in the waiting room a bit longer knowing she takes several extra minutes listening to her patients to get the full picture of their condition and needs.  But Steve called the clinic to make a get-acquainted visit with the new plan's recommended in-network doc. Yes, she's going to get paid by the old insurance now, and seamlessly (we hope) switch over to his new plan next year. He'll visit her in a few days to check her out. 

I hope she works out for him. I was on an "Advantage" plan early in my time of being on Medicare, just one year. I was given a list of possible "in network" doctors. Of those fairly nearby, I heard over and over that they weren't taking any new patients. The last on the list, farthest away, was open to more customers. I quickly found out why. His waiting room was nearly empty each time I went, and I was getting weekly blood tests there while on a blood thinner and needing testing. He had almost no personality, never asked how I was doing, just announced test numbers and whether I should change the dose. 

The minute Steve got a doc he really liked was just after I switched back onto "real" Medicare, so I switched to that same doc just a few blocks away. My next change was the one required by our relocating 1800 miles away. Just too long a commute!

What's fun is when various medical services back where we lived three years ago still reach out trying to remind me I need their services again. All have been notified that we no longer live in the state.  No, I'm not going there for an eye check, or a mammogram, or anything else! Sure, it would be covered. But how about the mileage, and cost of a motel and eating out?