18 October 2011

Medicare for Dummies

OK, I need to buckle down and do this. After two years of scrambling to patch together some kind of health care coverage that we can more-or-less afford, in December I finally become eligible for Medicare. Apparently there are decisions to be made. I'm a little apprehensive about this.

Fortunately, the Centers for Medicare & Medicaid Services provide a little (147-page) booklet:

Medicare and You 
This is the official US government Medicare handbook

Yes! Documentation! A user manual! As one of the infinitesimally small number of people on this planet who actually read these things, I find this very reassuring. It's filled with pictures of such happy people. If they've done this Medicare thing and they're still so cheerful, how bad can it be? Aside from the gray hair, most of them don't even look all that old. In fact, they look about my age. What's up with that? The print is comfortably large, I guess so they don't have to produce a separate large print version – accessibility and all that. Well, maybe not. On the back cover, it says it's "also available in Spanish, Braille, Audio CD, and Large Print (English and Spanish)." I wonder how large the print is in the large print version?

So I start reading. They put the index in the front, which seems odd. I don't know if I like the idea or not. On page 58, I find:

Things to Consider When Choosing Your Medicare Coverage

Excellent. This sounds like exactly what I'm looking for. They followed this with a bunch of questions:

Are the services you need covered?
Are you eligible for other types of health or prescription drug coverage?
How much are your premiums, deductibles, copayments, coinsurance, and other costs?
How much do you pay for services like hospital stays or doctor visits?
Is there a yearly limit on what you pay out-of-pocket?
Do your doctors and other health care providers accept the coverage?
Are the doctors you want to see accepting new patients?
Do you have to choose your hospital and health care providers from a network?
Do you need to get referrals?
Do you need to join a Medicare drug plan? 
Do you already have creditable prescription drug coverage?
Will you pay a penalty if you join a drug plan later?
What will your prescription drugs cost under each plan?
Are your drugs covered under the plan’s formulary?
Are there any coverage rules that apply to your prescriptions?
Where are the doctors’ offices?
What are their hours?
Which pharmacies can you use?
Can you get your prescriptions by mail?
Do the doctors use electronic health records or prescribe electronically?
Will the plan cover you in another state or outside the U.S.?
Are you satisfied with your medical care?


The Socratic method is just not working for me here. How the f#@k should I know? Isn't that what I'm trying to find out? If this is an FAQ, I've got the Qs. What I need are the As. And the $$. I need to know about the $.

Aside from the gray hair, I do not resemble the smiling, happy people in this booklet. Maybe I shouldn't have started in on it when I was already cranky about MetLife terminating my group life insurance because they aren't sure I'm still disabled. I wasn't really feeling open-minded and positive and cheerful.


If I put off dealing with this until I'm feeling open-minded and positive and cheerful, it'll never happen. That's just a fact. Aside from the gray hair, I never look anything like the smiling, happy people in this booklet. Maybe I'm going to need to grit my teeth and slog through this stuff anyway.

Maybe tomorrow. Maybe I'll do it tomorrow.



  1. I 'remember' our first encounter with that bible of services. Patti's MS symptoms of visual impairment and cognitive problems had already kicked in and it became my yearly reading. DO NOT miss a paragraph! - Though now days they actually have a fairly user friendly on line interface through their web site. And for what it's worth the writing has gotten better over the decades, I swear when I first read it that it was written by the same ghost writer that wrote the IRS forms.

    Caregivingly Yours, Patrick

  2. Yeah, sad to say but Patrick is right. Having to choose is a PITA. Good Luck!! I'm sure you'll be busy reading tomorrow.

  3. I'd been wondering how the stare-down with the Medicare envelope was going. Since your last post was about stalking, I figured you'd wisely decided to procrastinate.

    Thanks, ahem, for the preview of bureaucratic, nonsensical delights that await.

    Good luck -- may the force, some force, any force, be with you.