Thinking out loud

Today I am struggling to write in my usual Sunday morning fashion. Last week I was lamenting my folly about possibly hurting my ears by skydiving with a cold, and this week I have been tossing and turning at night thinking about Medicare and the lack of dental insurance. When I was employed, I had both health and dental coverage, and I never thought much about it. Today it's a whole different story. I waited until I was 65 to retire so that I could be covered by Medicare. And Medicare doesn't care anything about your teeth or your eyes, so you are left to cover that yourself.

If you aren't yet of Medicare age, hopefully by the time you get there the situation will be improved, or at least changed, from what it is today. The confusing number of options and how they affect you is astounding. I don't know how somebody whose mental faculties are diminished can cope. I consider myself smart and with all my faculties, and I am completely flummoxed.

It all started when I received a letter in the mail this week from my primary care doctor that he will no longer accept the Medicare Advantage plan I am currently on. If you only carry straight Medicare, only 80% of your costs are covered, and you have to find a prescription drug plan anyway. The Advantage plans cover both. Medicare has four parts: A covers your hospitalization; B covers medical insurance; C the Advantage plans, and D is drug coverage. Then there are private insurance companies who sell "Medigap" plans that cover the parts of A and B that Medicare doesn't cover. These costs together than be totally crippling. But, as many of us know, illnesses these days can bankrupt you forever, if you end up in a hospital for any length of time.

If you watch any doctor and hospital shows (like House or Grey's Anatomy), they never seem to consider the costs of all the tests and operations they perform at the drop of a hat. That's not the way it works in our country, for sure. You don't opt for expensive treatments, and if you have no insurance at all, you don't even get regular examinations. I cannot believe how much I took for granted in my employment: I was completely covered at no cost to myself in the early 1980s; at a very small cost to me in the late 1980s, but before I retired in 2008, the costs were horrendous. I was paying more than $400 every month out of my paycheck for MY portion of health insurance costs. My employer paid the rest and was busy trying to get everyone to move to something that required you to deposit $5,000 for each person into an account and draw from it.

I didn't worry; I was ready for Medicare, and I thought all my problems would be solved. NOT! At first, in Boulder, I enrolled in a Humana Advantage plan that only cost me $20 a month, and I would pay a co-pay at my doctor's office of $15 for each visit, $30 if I needed to see a specialist. It worked great, but then we moved to Washington state, where the same plan cost five times as much and was not accepted by most doctors around here. Humana is not very popular up here. You can only change your plan once a year, November 15 to December 31, but since I was in my initial enrollment period, I was able to change to something else. I spent countless hours on the phone trying to work all this out, but I finally decided to stay on regular Medicare with a Medigap plan, and a separate prescription drug plan. Even if you don't take any drugs, you are penalized for the rest of your life if you don't sign up right away with Part D.

It worked quite well for that first year, except that I was paying $200 a month (plus the $100 that Medicare deducts from your benefits for Part B), and I never saw the doctor except for a checkup. It seemed to be too much to me, so last year I moved to the Medicare Advantage plan that was accepted by my doctor and covered drugs, too. It worked so well... until now. Being forced to go back into the morass and figure out how to proceed has kept me awake so many nights. And the real problem is that there is nothing for couples, so if you figure that Smart Guy also needs coverage, and we have only our Social Security and annuities, you can see that the costs can spiral out of control very quickly.

Then there's the dentist. After checking into dental insurance, which is ridiculous in both its costs and coverage, I decided to just bite the bullet, pay all the costs myself. Of course not long after finding a new dentist, I needed to have orthodontic surgery and an old crown replaced. We are talking thousands of dollars here. I have also reluctantly concluded that the aforesaid crowned tooth is going to require a root canal, because in four months it still bothers me daily. Another thousand dollars into my mouth. All my savings are dwindling in order to keep myself from going into debt.

Now I know that there are so many people who have absolutely no recourse, no job and no insurance, so I should count my blessings. But the reality is that as I get older, my teeth will continue to cost me more; my health needs cannot be counted on to remain static; and I am approaching my 68th birthday. Not far from there to seventy.

Old age is not for sissies. It not only requires more determination to stay fit, but it also requires assistance from the health community. And the ability and income to access it.