17 November 2011

So Stop Dithering, Already!

From the moment that envelope arrived, I knew it would be trouble. It lurked, sullen and threatening, on the far corner of my desk, until I finally acknowledged the inevitable, and set Scarecrow to work on it with a very pointy letter opener.

Back in June of 2009, when I officially retired from gainful employment, December of 2011 seemed unimaginably far in the future. I had no idea how I would patch together some kind of spiderweb of health insurance coverage that would last until I finally became eligible for Medicare. Somehow, between the COBRA subsidy, Tuffy being a university student, and Scarecrow losing one job and immediately finding another, we seem to have managed it. Now I'm simultaneously extremely relieved, and very apprehensive. I've spent the last couple of weeks, off and on, trying to figure out Medicare.

The following probably won't be of interest to anybody who's already on Medicare, because you already know all this. And it won't be of interest to anybody who's not on Medicare, because you don't need to know about it. It won't even be of interest to anybody currently sorting through their Medicare options, because you probably don't have the same choices I do. But blogs aren't about what you want to read; they're about what I want to write. And I need to sort this stuff out. Just so you know.

So, Medicare.

My first option, as I understand it, is to do nothing. Being a lazy slime weasel, this has a certain appeal. If I do nothing, I'm automatically enrolled in Medicare part A, the original major-medical-type Medicare, and Medicare part B, which covers outpatient-type stuff. There is a premium for Medicare part B, which is automatically withheld from my Social Security benefit. This option has the advantage of being easy, cheap, and I can go to any doctor who is willing to accept what Medicare is willing to pay them. The downside is that it leaves some significant gaps in coverage, not least of which is that there is no limit on out-of-pocket expenses, and no prescription drug coverage.

Another option, almost as easy, would be to supplement regular Medicare parts A and B with what they call Medicare part D. This is a policy sold by a private insurance company to cover prescription drugs. Different companies offer different policies, covering different drugs, with different premiums and different co-pays, so figuring out the best choice for the drugs you take today, and for the drugs you may be prescribed in the coming year, is no small undertaking. Still, once you do your homework, this has the advantages of unadorned Medicare, and it covers drugs. It also leaves Medicare's coverage gaps, including the lack of limit on out-of-pocket expenses.

There is something called a Medigap policy, which sounded like what I was looking for: Medicare, with some of the gaps filled in. Turns out this is something insurance companies only need to offer to you if you qualify for Medicare by turning 65. If you qualify for Medicare when you're younger than 65 – like because you're disabled – most states don't require insurance companies to offer you this kind of policy; Washington doesn't, and they don't. Next!

OK, now it gets complicated. Medicare part C, as I understand it, is a policy sold by a private insurance company. It replaces Medicare part A and Medicare part B, usually with some additional coverage, maybe including drug coverage but maybe not. Some policies limit you to providers in their network but some don't. They have different premiums and co-pays and coinsurance and drug formularies and a million other moving parts. The Medicare website offered to help me compare the 53 plans that are available in my area. It took a while, but I finally managed to narrow it down to two. The major difference between them is that one plan limits you to providers in their network – and it's a pretty small network. The other plan has a very large network of providers, including the family practitioner, neurologist, rehab specialist, physical therapist, and occupational therapist I've been seeing for the past couple of years, and is somewhat more flexible if you don't find anyone you like. It would also probably cost about $1500 more a year.

So after all that comparing, and what-iffing, and back-and-forthing, and endless dithering, it comes down to this:

You get what you pay for. And you pay for what you get.

15 November 2011

Might As Well Start Now

If you say you'll laugh about this one day, you might as well start now.

After yesterday, I've been laughing so much my ribs hurt.

It was one of those days. It started out with getting packed up to go into Scarecrow's office at Gloria's Books and Adult Day Care. He has mostly been working from home, which is amazingly wonderful for a number of reasons, but occasionally a little face time is required. As usual, I was going along, to hang out in an empty corner of the warehouse, entertaining myself and generally staying out from underfoot. Since my laptop is what I use to keep myself busy and out of trouble, I was trying to be unobtrusive about watching Scarecrow pack it up, to make sure that the earbuds and microphone and AC adapter and other bits all made it into the bag.

The commute to the other end of town wasn't too bad, all things considered. Even in Seattle, a little rain can do bad things to rush-hour traffic. It was only after we got there that Scarecrow realized that he had left my carefully-packed laptop at home. (Carefully-packed lunch, too, but it is possible to get lunch in Renton, if need be.)

Well, without my laptop, I'm pretty much screwed. Ironically, at one time, a day in a book warehouse would have been my idea of a really good time. Now, although I'm surrounded by books on just about any topic you can imagine and some that you can't, I can't pick them up, can't turn the pages. Screwed.

Not only that. I use the laptop to IM Scarecrow when I need his help; like for a bathroom break. Screwed.

Well, whatever. I can use the time to practice meditation. I've been meaning to do that. Or I can do some serious napping. Whatever. It's only eight or nine hours. No big deal.

So as I pulled into the wheelchair lift to negotiate the 4 feet between the parking level and the warehouse door, I was chatting with Scarecrow, secretly congratulating myself for not going postal over the carefully-packed laptop still sitting next to the front door at home.

"We're not there yet," I said, when the lift stopped halfway up.

Scarecrow pressed the button again. He turned the key off and on, then pressed the button again.

"It's not going," he said. "It's stuck."

He checked to make sure the doors were closed, and the power appeared to be on, and the other obvious stuff. Nothing. It was going just a minute ago. It was working fine. It just stopped.

OK, a couple of minutes ago, when I thought I was screwed? I really wasn't. Now I'm screwed. 

The maintenance guy who takes care of this kind of thing wasn't in yet. I'm sure this was just the kind of thing he was looking forward to on a Monday morning – a medium-sized old lady in a 300 pound power chair stuck in the lift.

I have to say he took it very well, particularly considering that this wasn't the only disaster awaiting him; one of the conveyor belts in the warehouse was stuck, too. After messing with some fuses and circuit breakers and other obvious stuff, he conceded that he had no idea what the problem was with the lift. He called the company that serviced the thing, stressing that with a medium-sized old lady stuck in the lift and it looking like it was about to start raining any minute, this was a problem of some immediacy. They said they'd be there in 10 minutes. Maybe 15.

It probably wasn't any longer than that, but I've got to tell you it feels pretty stupid, being stuck 2 feet up a 4 foot lift, waiting for the rain to start.

The lift guy used a 1 1/8 inch socket with a nice long lever to crank the lift up manually, about an angstrom at a time. Whatever works.

Once we were inside, Scarecrow set me up with a movie on his iPod Touch (have I mentioned that I'm easily entertained?). That was working fine, until a reminder popped up, stopping the movie and taking over the display. And bonging. And bonging. And bonging. And bonging. And bonging. Now, Scarecrow is pretty hard of hearing, and he's got that alarm set so it'll get his attention if the iPod is in his pocket. I was getting it through earbuds. Since I couldn't dismiss the pop-up or take out the earbuds, this went on for 15 minutes, bonging, and bonging, and bonging, until the device finally gave up.

After the bonging stopped I got some time to practice my meditation, or maybe I was taking a nap, when Scarecrow stopped to check in. He dismissed the pop-up, and restarted the movie.

Five minutes later, the reminder popped up again. He had obviously hit Snooze instead of OK. Bong. Bong. Bong. Bong. Bong.

The next time Scarecrow stopped in, he said he was going to talk to Bob (of Bob's Books and Adult Day Care), and then we'd call it a day. Since he was only going to be a few minutes, he packed up the earbuds, set the iPod on the desk, and went off to talk to Bob. Five minutes later, the reminder went off again. Bong. Bong. Bong.  Now I remember – there's no such thing as a short conversation with Bob. Bong. Bong. Bong. By now it's really pretty funny. And as long as it's not going off right my ear, I can laugh.

Might as well start now. I know I'll laugh about this someday.

The little rodent who had built a snug little nest inside the lift machinery, only to find out there was a good reason that nobody lived there? Well, he had the worst kind of bad day.