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Medicare Mini-Survey

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category_bug_journal2.gif Next Monday, 15 October, begins the annual Medicare enrollment period during which those who are eligible may make changes to their health and prescription drug coverage for the year 2013. The enrollment period continues until Friday, 7 December.

Nine weeks would seem like a long time to get a tedious and sometimes confusing job done. But last year, so many people put off the task until the last week that the federal government had to extend the deadline by three days.

So, next Monday's post here will be stuffed with facts and information you can use to help make the decisions before the deadline whether you are enrolling for the first time or already a beneficiary perhaps looking to change plans.

Personally, I don't believe it's nice to subject elders (or anyone) to the huge number of choices each year that cannot easily be compared. Single payer/universal coverage would, of course, fix that problem.

But, given what passes for Congress these days, I doubt that will happen in our lifetime so we're stuck with this odious annual ritual. I'll try to make it as easy as possible for you and point you to places where you can get additional help.

Meanwhile, today, I'd like to do a little survey. It's not scientific. It will have no meaning in terms of numbers and percentages. It doesn't even lend itself to being counted.

But it will help me for next week's story and might interest you. Just two questions for you to answer in the comments below.

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Here are the questions:

1. What single thing do you most want to know about the Medicare sign-up? Understand that I cannot answer questions about specific personal complexities. I'm seeking to find out what generally would help you get through this process as easily as possible.

2. What do you think of Medicare? Given that single payer is not an option at this time in American history, do you like Medicare? Does it work for you? What don't you like? What would make it better for you?

The first question will help form next week's post. The second is just curiosity on my part.

At The Elder Storytelling Place today, Johna Ferguson: Friendship


I just have to say, I admire the hell out of you for being willing to do this to help others. The stuff you regularly study and digest has got to be some of the driest, most complex verbiage ever put to paper.

Thank you.

Oh, Sid, thanks.

You're right - a lot of it is dry and tedious. But if I didn't have this blog, I'd need to do it for myself and reporting it here gives me greater impetus to make it clear for myself.

This isn't entirely altruistic, you know - heh, heh.

I'd like to know more sbout prescription drug coverage.

I'd like to understand the advantages and disadvantages of a Medigap policy vs. a Medicare Advantage policy.

I too would like to know more about prescription drug coverage. I don't require any expensive prescriptions, but of course that could change. For now, as in the past, I am "self-insured" i.e. I pay for my prescriptions myself.

So, my two responses:

1) At what point (cost-wise) does Plan D become worth its cost?

And 2) Yes, Medicare (and Oregon's ODS supplement) are working very well for me, except for that clunky boondoggle, Part D.

Thanks again Ronni for providing all your excellent skills: web design, implementation, maintenance, execution, stability and peerless content.

And thank you particularly for providing an informed voice for all of us, old or not, who have no other place to turn for information not biased by wild-eyed reactionary politicians or rapacious corporate interests.

You are truly a blessed media phenomenon.

We all love you.


1. No questions
2. Medicare is good for me, prefer single payer of course but little hope of that in this country.

Great service your provide, thanks, and keep up the good work.

Ditto Jim Smith's request, I have no clue as to the difference. We are hanging on to my WA State employee Medicare supplement because it covers longer hospital stays/nursing facility stays than most other plans and we don't have a long term care policy. But it costs a bit more. Wouldn't it be great if we could see ALL plans explained using the exact same format, so we can compare more easily?

1. What single thing do you most want to know about the Medicare sign-up?

I like what I have. Can I just do nothing and have everything stay the same?

I'm lazy and going on vacation. I just haven't checked that yet.

2. What do you think of Medicare?

Medicare with it's Medicare Advantage plan that I get through AARP is a good one. They do not always cover the meds, and on occasion the meds are very expensive per month.

1. I will be a first-time sign-up with Medicare. I thought I was supposed to sign up in December, so I don't even know if I'm supposed to do anything right now or if I'm supposed to wait. My husband says I shouldn't sign up for Part D because it won't save us any money, that it will cost us more than we currently pay for the drugs themselves. I'm very confused about the whole thing.

2. Since I am a first-timer I don't have any preconceived likes or dislikes except that I wish we had a single provider.

I, too, have been confused about Medicare Advantage plans. In today's NYT, David Brooks has a column about Medicare reform. There are a great many comments and in one of them there is a reference to an explanation of Medicare Advantage by the Kaiser Family Foundation in Sept 2008. I found it interesting and understandable. The link to the study is I hope this is permissible, Ronni. We all need all the information we can get it seems. Thanks for all you are doing.

Well, that's just great! Just posted the link to the Kaiser Family Foundation, clicked on it from the post and it doesn't work, although it did from the comment in the NYT. Sorry about that.

My Home page for KP is
Also, you can just go to Google search and type in Kaiser Permanente and you'll get several links right away that you can click on.

I love my Kaiser-Permanente Senior Advantage program so much that I wouldn't change it for the world. I don't even bother renewing, I just let it stay on KP as a default.

Have never had better care in my life ... and I've in a lot of different cities and had a lot of doctors looking after me in my 75 years!!

Me again. The fact sheet on Medicare Advantage from Kaiser has been updated to 2011. The link is Hope it works for those who are interested.

We got some confusing stuff about changes to our Kaiser plan. My husband and I are putting aside some time to puzzle over it.

We also have Kaiser Senior Advantage and are in general quite happy with it. I am just wondering what will be the effect to it when the changes from the new health bill take effect. Fortunately we are both in reasonable good health sow we have not had to use it very much.

Thank you for sharing all this information. I am not sure I have the capacity to do the research now on my own. To answer your questions:

1. I need to have more information on the different plans offered. It would be helpful if every insurance company in each state is forced to submit all of the basic charges to a single provider and that provider would, in turn, make a flow chart comparing the differences. IE: Fees. Co-pays. Number of days covered for hospitalization and re-hab, etc.

2. I am grateful for Medicare.

What I don't like is the Insurance HMO's using different doctors and if you change from one company to another (due to cheaper or no co-pays for specialists, for example) you usually have to change all of your doctors. While this is not true if you are on basic medicare, it is less costly to join an HMO and many of us use HMO's.

I'm new to Medicare this year, coming from my husband's employer-paid group plan. We live in Washington State.
1) I think I can go online to compare drug plans (Part D) like I did when I signed up. Is that true? I've already received formulary & pricing changes from my current plan, so I guess it's worth re-visiting. It's amazing the difference in how much different plans charge/cover for the same medication. Amazing.

Also, I would like to know what hoops you have to jump through, if any, in order to switch from Medicare Advantage to Traditional Medicare. If I did that, can coverage for pre-existing conditions be excluded -- forever or for several months? Pre-existing conditions were waived when I signed up for Medicare Supplemental initially because I was going straight from a group medical plan to Medicare, but it appeared that their health questionnaire would apply if I signed up at any time after this initial grace period. Same question about switching from Traditional Medicare to Medicare Advantage. This is the main reason I hesitate to join Group Health Medicare Advantage (below).

2) Under my husband's employer-paid plan we had coverage for acupuncture, naturopathic physicians, and PT/OT for chronic conditions, e.g., pelvic floor issues. None of this is covered under Medicare which provides coverage for pretty much the lowest common denominator of services covered in other states. These were my primary care physicians -- even though I also used MDs for specialty care -- so I had to do a lot of doctor switching. In the State of Washington, we have a 5-Star Medicare Advantage plan provided by Group Health Cooperative. Many of my senior friends use and LOVE it. I had some continuing medical issues when I started Medicare this year, so I needed to continue using my out-of-network physicians. I love the coverage (deductible, co-pays) provided by my supplemental Plan F but, unfortunately, it doesn't cover any service that Medicare Parts A & B don't cover -- like acupuncture. Group Health does.

Although I love Medicare in general, it was really helpful to have an insurance agent I trusted help me sort out plans that, in her experience, provided great customer service, were solvent, and met my needs at the lowest annual cost. Agents make a commission on any product they sell you, but your plan cost is no different whether you use an agent or not. So although I did a lot of reading on the web site, as well as using our state's SHIBA volunteers, it was great to have this free knowledgeable help.

Thanks so much for all the service you provide in your blog, Ronni.
- Cat

I look forward to your story next week, and thank you so much.

The comparisons of Medicare Advantage plans are confusing... often apples and oranges.

I do not like the advantage plans mostly because of the very limited provider networks. They amount to a voucher system and right now the insurance companies are working hard to make them most attractive with zero copays and extras (vision, dental, health clubs, etc.) But cost sometimes must be the deciding factor.

I would like to know more about how to best use basic medicare to full advantage - with or without Medigap and drug plans?

Hi Ronni - Hope you are well!!!

1. no changes for us - we use CVS Pharmacy and the Aetna Pres. Plan

2. We only have Medicare - and if God forbid we get really sick it is going to be Medicaid or bye bye!!!!

1. no questions.

2. I am very happy with Medicare as it stands now. Of course, we all would like to have the government pay for all of our medical care. Fortunately for us, my wife's insurance provided by the place he used to work pays the balance of what Medicare will not pay for me.

The one thing I am concerned about, is the possibility of the government reducing the amount they pay to doctors who are now serving the senior citizens. I talked to my doctor about it and he tells me that many of his associates are threatening to stop accepting Medicare patients or they are threatening to leave the associations they belong to now and go out on their own where they can start from scratch. I don't like hearing rumors like that. I hope it's not true.

In my state, Minnesota, there is a state agency which will meet with a senior and/or family member to go through the choices and costs to assist in getting the best plan for the individual. This includes the Part D med plans. I found it very helpful when getting my mom on a new medicare plan. Not sure if other states have this option. It is part of the dept of human services here and is called Senior Linkage. They also help out with many other senior issues.

My husband and I will not qualify for Medicare for 1 and 3 years, respectively. He may need to retire before qualifying, and we are in the process of applying for VA medical coverage for him in case this happens. How does Medicare interface with VA care? Can a person use both at the same time?

Although we have not yet had experience with Medicare for ourselves, our involvement with my elderly in-laws has provided some education. Although my MIL has advanced Alzheimer's, she has had few physical issues over the past several years, and hasn't had much in the way of medical costs, other than her RX. My father-in-law had a bad fall, head trauma and neurosurgery during the last year of his life and had a few ER visits and a couple of overnight hospital stays during that time. He and his wife have had BC/BS for their supplemental insurance the last few years, and, other than a little RX cost, he never had to pay anything for all his medical care that last year. So as long as we can afford as good a supplemental (but we probably can't) I think I would like it very well. Like others here, though, I would much prefer a single payer option.

1. Same question as voiced above--advantages/disadvantages of basic Medicare over the Medicare Advantage plans. My primary MD is no longer taking my advantage plan after 1st of year. I chose this plan over a medigap as I'm basically quite healthy and require only basic maintenance visits. Am I "wrong" to do this? I no longer have to pay for my fitness center visits. As for Part D, I pay no more for my prescriptions (self pay) than I'd pay if I had a Part D plan. Of course, if I got sick, it would be another story. Is there a point at which we SHOULD subscribe to Part D?

2. The medicare advantage plan has worked well for me to date. I'd prefer universal coverage.

Like many others here, I wonder about Medicare Advantage, which I currently have through AARP, and regular Medicare. I'm pretty healthy as of now and like the freedom from monthly premium payment with Advantage, but the co-pays have gone up and I'm wondering if I would still ilke Advantage if my health were to decline.

Medicare is as close as we've got to a single payer system and I think the age limit should be wiped out and we'd be much better off as a nation.

I live in a small town, so my Medi-care choices are limited to one, or none by my former employer.

My biggest peeve is watching my peers go to numerous and expensive Dr's appointments which could be handled by a nurse-practioner for much less money and probably with better results. Also, the waste of paperwork that comes with each and every piece of information that is sent out.

No questions re Medicare.

We use a Medicare Advantage Plan from Aetna which works well for my partner and myself. This plan covers prescriptions and also provides for assistance with hearing aids.

Thank you for doing this Ronni.
While I have no questions about Part D, just interest at this time, I do have a comment about Medicare.

It works well. What makes me sad is when I talk to people who can't wait until they are 65 so they can finally get affordable insurance. That does not speak well for our country.

1. A standard comprehensive outline that the government and insurance companies must complete and distribute at first contact that lists the coverage, limitations and exclusions, and costs of Medicare Parts A,B, and D, and Medicare Advantage Plans. The same for the numerous Medigap plans available from many companies. To be presented in the form of an easily comparable chart. Will save many hours of phone calls and tedious comparisons now needed to be done by the applicant.
Repeating a previously asked question: "At what point (cost wise) does Plan D become worth it cost?"

2. Good so far considering the alternative of paying the unconscionably high costs of medical care. Drugs should be included in basic coverage, not a separate electable part. Dental care, eye care, and hearing care should be covered. They all are related to good/ill health.
The penalty charged if Part D is not subscribed to originally is without merit. The "donut hole" is unreasonable. The higher cost of medications for those who need a lot would be balanced by those who use little to none.

I'd like to know why the site only allows a 30 day prescription when searching for a Part D provider. That backfired on me when I signed up with the info I was provided because they won't cover 90 day prescriptions.

I'm very satisfied with Medicare, but I would prefer to pay the additional premium directly to them rather than wade through the large number of companies offering Medigap, or supplemental insurance.

It's clear to me that most people gravitate toward the Advantage plan with the same company that's covered them because it's so incredibly difficult to sort out all the info.

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