Yo, Boomers! Medicare’s Hidden Traps
I voted for Elizabeth Warren in the Democratic primaries. I also like Bernie Sanders and went to rallies for both of them. I was happy to cheer along with their proposals that people on the right seem to think are pure communism and the rest of us know are just common sense, but there was one part of their platform I couldn’t cheer for and that was “Medicare for All.” Don’t get me wrong. I believe that every single person in this country deserves adequate and accessible healthcare. And if Elizabeth and Bernie can figure out a way to pay for it, I’m all for it.
The reason I couldn’t cheer for “Medicare for All” is a more personal reason. I had just witnessed how the government’s arbitrary rules for signing up for Medicare had left my ex-husband hanging out to dry after he had a debilitating stroke. He missed the deadline for signing up for Part B by two weeks. That little misstep cost close to a hundred thousand dollars in hospital bills, doctors bills, equipment bills, and therapists — money that might have gone to our daughter after his death to pay for her schooling or for a downpayment on a house.
This isn’t a rule that’s widely advertised. If you’re the sort of person who lets things slides or doesn’t do adequate research (and, let’s be honest, this describes a lot of us) then you wouldn’t know you have a window to sign up for Medicare insurance, and if you miss that window you are shit out of luck, as we say in the south. You won’t get the coverage for a good nine months.
Fortunately, my ex had gotten some money in an inheritance just before this happened. So we were able to get the things he needed to try to recover from the stroke. Without that money, he would have lost everything including his house, and he would have spent his final days in a Medicaid nursing facility. Let me tell you, you do not want to spend your last days in one of those places.
When it came time for me to sign up for Medicare, I was uber-careful. I questioned everyone I knew about their experiences. I made an appointment to speak with someone official at Social Security. I read every single rule on the website. I made sure I signed up correctly and in a timely manner. And yet even with all that, I find they still are trying to sink their hook into me.
The boring, technical part:
Everyone is supposed to sign up for Medicare Part A when they turn 65. So I did that. But they have a provision that you don’t have to sign up for Part B as long as you have private insurance with your company. I was still working so I kept my private insurance. The thing is, Part B isn’t free. I didn’t want to get it as long as I had other insurance.
Then I retired. According to the website, I had eight months to get Part B. But this is a terrible time not have health insurance. So two weeks after my private insurance ended, I signed up for both social security and Medicare Part B, which was well within the “special enrollment period” of eight months. But it took about eight weeks of going back and forth with the SS office to finally get my card. As soon as I got my card, I signed up with a Medicare Advantage program which includes prescription drug coverage. Cool. I’m done, I thought. Of course, that coverage wouldn’t start for another two weeks. That means I was basically without prescription drug coverage for three months. No big deal. I only have one medication and it doesn’t cost much.
And that’s when I got a notice telling me that I could possibly be subjected to a “Late Enrollment Penalty (LEP)” because I went more than 63 days (???) without prescription drug coverage. According to the Medicare Advantage Quickstart Guide: “If you have an LEP, you’ll need to pay it as long as you have Medicare Prescription Drug Coverage.” In other words, if you fucked up by a day or so, you will be paying a penalty for the REST OF YOUR LIFE.
So here’s why I think this is pure evil, money-grubbing crap dreamed up by Franz Kafka: WHO CARES WHETHER OR NOT I HAVE PRESCRIPTION DRUG COVERAGE??? No one suffered because I didn’t have coverage for three months. I didn’t even suffer because I had enough of my medication to last me 90 days! And what if I didn’t have any prescriptions? I surely wouldn’t be worrying about having coverage for drugs I don’t take.
According to our handy dandy guide, “This penalty is required by law. It’s designed to encourage people to enroll in a Medicare Drug Plan when they are first eligible.” No, it isn’t. It’s designed to take advantage of people living on a fixed income who may not be computer savvy or who may have any number of reasons for not signing up within 63 days. I suppose they could say they want more people paying into the pot in order for the program to work. But really, it’s not the actual insurance — it’s just prescription drugs.
So what I did I do? I called up the Medicare Advantage Plan to say WTF? The woman I spoke to had no idea how to help me and told me to call Medicare. Since I had signed up for Medicare with the social security people, I called a woman I had spoken to before who had been helpful. She told me that they are two separate entities (even though you sign up for Medicare with Social Security) and told me she couldn’t help me. So I found the number for Medicare and that woman couldn’t tell me anything either and said to go back to the people I’d called in the first place.
As of now, this is not resolved. I think I might win because looking at the Medicare website it says you must have coverage within 63 days after the open enrollment period. I can only assume that applies to the special enrollment period as well, and so I should be in the clear. But who knows? If I lose, then I’ll be paying a penalty every month from now until I die.
I shouldn’t complain, I guess. We’re lucky to live in a country where we get social security and Medicare. There are a lot of people out there who would like to take that away from us. They call it an entitlement, even though we paid into our whole working lives. Nevertheless, I’ll be okay.
And yet, I can’t help but think about people who don’t have access to a computer or who find all the arcane rules baffling. Or those people who are living only on their social security and every single dime of it is necessary to their survival. What if they screw up and don’t jump through the hoops of flame that the government circus requires? They will pay and pay and pay…
I know I’m being long-winded here and starting to sound like those anti-government windbags. I just think we should try to make this a more humane (and less arbitrary) system. And if you’re at that time of life when Medicare is an option, beware. There are traps out there.
