Wednesday, December 5, 2018

Medicare and Me - Part 1,000,000,000,000

It's been an on-going saga.  I sent in my paperwork in October, the week I received it.  The deadline for signing up is Friday.  As of this morning I had heard nothing from the agent who was charged with figuring it out for me. 

My phone calls became progressively more desperate over the last few weeks.  I've called early in the week, and late in the week, in the morning, in the afternoon.... it made no difference.  So, this morning, I pulled out all the stops.  TBG was listening from the bedroom; "That got their attention, I'm sure," was all he could say.

At 4:15 this afternoon, I was sitting in the agent's office, my paperwork in front of me, her apologies pouring from her lips.  None of this was my fault.  She has been overwhelmed but that's not my problem.  Nothing can make it be okay.  I shouldn't have been worried.  She was truly sorry.  I have to respect a woman who accepts responsibility without asking to be excused for the consequences.  We decided to smile and move on, with me secretly applauding myself for acting with such maturity. 

As she was explaining the differences between Medicare and Medicare Advantage Plans and the Drug Plan we were discussing because that deadline was looming, I began to appreciate the enormity of her task.  There are so many companies, and so many drugs, and no two of them appear on the same tier as you look around the plans.  Lorazepam is Tier 1, Tier 2, Tier 3, with accompanying price increases, on three different plans.  Some let you shop at WallyWorld, some at Walgreens, some at CVS.

For us, the plan at CVS offers free drugs.  No co-pay at all for my meds, $1.36 a month for TBG's.  I signed the documents, shook her hand, and walked out with my needs met until we meet in January, when the new Medicare Advantage Plans become available. 

I also had a new fact to nibble upon.  Part of the reason my agent was so busy revolves around Blue Cross and their inability to reach an agreement with a large practice here in Tucson.  Apparently, the physicians felt that they could not offer quality care if they accepted Blue Cross's offer - a fraction of what their time is worth.  Instead of accepting the deal and complaining about it afterwards, the practice walked away from the insurer.

6,200 of their patients walked away, too.

Really, the agent mused, what was Blue Cross thinking?  Would you walk away from your doctor to stay with your insurance company? 

Physicians for social change.  Transparency in medical costs.  Standing up for what you believe in.  Trusting the client to make the right choice.  Confidence in the product you offer.  But, mostly, somebody saying NO to an insurance company and not only getting away with it, but getting away with it in a huge way, hitting them in the pocketbook, where they might notice it.

That, on top of winning at cards earlier in the afternoon, made this a pretty delicious Tuesday.


  1. We're insulated from this process because we have (and pay dearly for) a supplement from our former employer, thus I know nothing, so excuse what may be an idiot question.

    Do you have to change carriers every year?

    That just sounds awful. I am glad you have someone to help and don't have to do this on your own. Friends of mine in the NW have been forced to change coverage as doctors dropped out of plan due to lack of reimbursement, but there are so few doctors they have to change carriers.

    1. You don't have to do anything. But if you don't, you are grandfathered into whatever our plans morphs into. And every plan, every year, changes. The only similarity I've found is the $415 deductible in every drug plan. Apparently, that's the maximum the gov't allows, so they all take it.


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