Medicare explained: Your monthly premium will be $0

Want to drive yourself completely mad? Help someone subscribe to the confusing insurance that supplements Medicare.

I don't mean supplements unless we're talking about Medicare Supplements which is different from Medicare Advantage plans, which may or may not be the official name of them, no, sorry, it is the name of some of them, which probably are Medigap plans that address the Medicare doughnut, which is not something you eat because if you're paying for it you don't have any money to buy food unless you never go to the doctor which you most likely would not be able to do because any doctor you've ever gone to or possibly heard of doesn't take whatever plan you're on, which is OK because you wouldn't be going for your annual physical anyway since Medicare doesn't pay for that, a nod, I would venture, to its illogic that prevention is not that profitable so why bother with that so having learned all of this through approximately three weeks on the phone during which time you contracted, suffered from, and recovered from at least the seasonal flu and perhaps swine, which you can't be vaccinated against due to the fact that you're not in a high risk group even though you got it, you call everyone else you know who had to sign up for insurance that lives in the neighborhood of Medicare whereupon you learn that, to a person, they impulsively signed up for something rather than jump out the window which would be unfortunate since your daily co-pays are so high that you'll lose your house if you even drive near the hospital, at which point you call your relative's primary care provider's office for the thirty-fourth time to discover that the doctor whom the insurance company just told you was covered by the plan is not covered by that plan ("it's a mistake on their site and we can't get them to fix it"), whereupon you scream ohmygodcanyoupleasejusttellmewhattosignhimupfor and the primary care's insurance expert, having run into this a time or two before, pulls the standard answer out of the pile, which is that there is only one plan that the office has a contract with and even though you've never heard of the plan and are slightly suspicious because when you look it up on their site you see that the monthly premium is $0 and think naturally it must be a total typo, leading to seven more hours on the phone wherein you make the insurance company representative swear in court that the premium is $0 (don't ask, Medicare just pays them a lump sum so they don't need to charge you, the consumer), which seems completely like a total lie and certainly has been designed to catch you out on your first claim, well, you're so exhausted by this point, not to mention your poor relative who's very good at abstract systems thinking and, shall we say, less inclined to tolerate this kind of thing, but who because he unlike you can read manuals actually reads the whole 3000-page document the government sends out, which means he knows a gap from a doughnut and you just say, ok, sign him up and if you never hear from me again it's because I have, as you can see, gone completely bonkers.

It's not covered.

Comments

[Paul Levy]

Ah, you understand it perfectly.

[Jessica Lipnack]

...or I finally have the material Ive been searching for for my stand-up routine. Hire me. I do hospital bazaars.

[Virginia]

From Virginia, via Facebook:

Well written...and reads just like the policy...we just need a public option!!

[Facebook porting]

From Pat via Facebook:

yesssss virginia - now if only there really were a Christmas..

[Facebook porting]

From Pam via Facebook:

Well, I thought I was one of those analytic types until I tried to compare plans...

[Facebook porting]

And from Pam again on Facebook:

Yes - every company has different tiers for the drugs; most plan sites tell you copays, but not all of them tell you the full price of the drug which is crucial in order to calculate when you might hit the donut hole.

[Facebook porting]

David from Facebook:

Do you think there might be a buiness in franchising" Donut Holes for Medicare " ? Certainly, it is lower calorie and less carbs than alternative franchises, and this will help with the obesity crisis.

[jessica lipnack]

My responses on Facebook:

David, you've landed on a great start-up. The only problem is that as soon as you've got the business up and running, they're certain to switch to "sieves" or some other incomprehensible loophole that will completely deflate your business model. I really think a mental hospital just for people trying to understand Medicare is the only sure ticket - and much needed.

Pam, and don't the full price quotes vary from pharmacy to pharmacy to boot?