THE BEST-LAID PLANS

ORIGINALLY PUBLISHED BY THE SOMERS RECORD (05-18-23)

 

      Recently I received a card in the mail congratulating me on my upcoming birthday, which isn't until Christmas. To celebrate, I was invited to a local restaurant along with several of my close friends whom I have not met yet, for the purpose of discussing Medicare, for which I am not yet eligible. But since the invitation happened to arrive before dinner, I hungrily accepted.

     If you should you ever need to limit your food intake for any reason, the best way to ruin your appetite is to talk about health insurance. Further, just about everything I might order at a restaurant has been proven to exacerbate one medical malady or another, so I had to weigh my dinner order against my insurance deductible. Thank goodness we were not eating at a gastropub, which sounds like it might cause something I'd need an out-of-network specialist to cure.

     You've seen commercials like this a million times on TV: a really annoying wife is beleaguering her husband to decide on a Medicare plan, and she won't shut up until he makes that call to the insurance agent. In my dreams, the husband finally hits her over the head with a "Terms of Agreement" clause and commits Medicide, but he can't collect any insurance because of her pre-existing condition: she was ALWAYS annoying. For some reason it's always the woman who is super-irritating, but statistically the annoying gene is evenly distributed among gender.

     I entered the restaurant thinking that we would be talking about how FINALLY the Federal Government would be picking up the tab for once, but it became abundantly clear that nothing was abundantly clear. Once we started hearing about the different factors that affect your coverage, I realized that the Federal Government's plan was much different from mine. Their job is to ensure that I have medical coverage for the rest of my life, but if I happen to drown to death in paperwork it would be to their advantage. It was a sobering conversation, so thank goodness alcohol was available.

     Here are some things I learned: 1. You should sign up for Medicare Part A when you become eligible, to avoid penalties, especially if you are a hockey player prone to penalties. 2. For most people, Part A is free if they have worked for the last 10 years, even if they haven't worked that hard. Part A covers hospital-related costs. 3. If you have insurance through your employer, you should sign up for Part B within eight months of whenever you lose that coverage. Part B is doctor's care and medical equipment. 4. Part D pays for prescriptions, but you need not enroll if your job gives you coverage that Medicare deems comparable to its own, even if you find it ironic that you are engaged in a conversation with your employer about who will buy your drugs. As we figured out which letter of the alphabet was responsible for what, I realized that no important decisions should be made while dessert was being served.

     I imagined that my first post-medicare injury might go something like this: I'm in my car following a big truck that has a sign that says, "How's My Driving?" and lists a phone number that I can't read because I don't have my glasses on. I think he's driving great and I'd like to let the company know and also complain about some of the drivers behind me, so I pull up to within six inches of his bumper so I can read the number, but the truck driver thinks I'm tailgating him and floors it, which I think is reckless, and now I want to call to report that, so I pull up again to see the phone number, and just then a squirrel starts to cross the road in front of the truck, then stops because he forgot something, starts back where he came from, then realizes he doesn't need whatever he forgot and proceeds to run back across the street, and the truck stops short and I ram into it. The truck driver for some reason is angry at ME, when it's the squirrel who caused the accident. What could a squirrel forget that's so important, his keys? Once I get the Medicare guy on the phone asking him if this is a Plan A, B, C or D situation, he tells me he has to check the alphabet to see if any new letters have been added.

     All things considered, I learned a lot from the presentation, had a great meal, and found out that because everyone's situation is slightly different, there is no single great solution. Another important take-away is that when you are discussing both health insurance AND the Federal Government at the same time, it's not a good idea to supply everyone with knives.