20130709 – Health Care Messes
Seems as though our wonderful government has done nothing but muck up an already confusing health care system, and left “We the People” in the dark. Even the Medicare and health insurance professionals are at a loss to explain anything satisfactorily if our experiences of the last week are any indication. And of course, us sandwich dwellers are left to puzzle through the puzzle pretty much on our own. It’s no wonder my 88 year old mother-in-law is happy we’re trying to deal with it and begging us to not mess it up!
Mom has Medicare, Blue Cross through the school employees’ retirement system, let’s call it BC-SERS, and Blue Cross through the university’s retirement system, let’s call this one BC-URS. Medicare is primary, BC-URS is secondary, and BC-SERS is tertiary; she’s had this coverage arrangement for years with no apparent issues. Because she pays premiums for both of the non-Medicare plans we’re reviewing her coverage to see if we can reduce her health insurance costs.
First, no one seems able to provide us a plan summary that says what is covered and to what extent it is covered. We have to dig through her paperwork and see what we can find. Second, no one seems to be able to explain how the various coverages coordinate. And third, no one can explain what, if any, impact Obamacare will have on their program, although it’s become pretty obvious that all programs will get much more expensive, add tons of red tape, and result in less coverage.
In the midst of our investigation BC-SERS notified Mom they must set her up under a Medicare Advantage plan and they say she can only have one; if BC-URS sets her up BC-SERS Advantage Plan is automatically cancelled. So we called BC-URS several times over a period of days and finally got someone who can answer our questions, only to be told Mom can’t be double covered at all outside of Medicare, she can only have Medicare and one private plan. Of course their plan doesn’t cover dental and vision, so she can keep the other plan for those two, just not for general health care. So where did this apparently new rule come from? Who knows; probably another Obamacare mandate. And we still don’t know exactly what is and is not covered under the plans – kind of hard to make an informed decision; we might as well head over to the bar and throw darts.
And that’s just the bottom half of the bun in this sandwich. The top half of the bun has its own problems; the kids don’t have health care. Both are self-employed, and one has a part time job less than 28 hours per week so health care is not offered. They’re still digging out from some unplanned emergency care expenses and trying to figure out how to get affordable health insurance so they don’t have to pay the tax required of the uninsured. Businesses just got a one year reprieve from their health care sentence, but not the people. The tax on individuals hasn’t been postponed, at least not yet.
A short time ago former Speaker Pelosi said “we have to pass the bill so we can see what’s in it”, one of the most stupid comments on legislation I’ve ever heard. And of course now that they’ve passed the legislation and it’s being implemented, we still don’t know what’s in it! And nobody can explain it to us, but we’re sure going to get stuck paying for it.
So you sandwich-dwelling Grasshoppers, the point of this tirade: Before your doctor sticks his finger you-know-where, start now to learn everything you can about your health insurance, your parents’ coverage and your children’s coverage. It may take you the next six months to sort everything out and you definitely do not need costly surprises.
Meanwhile, my dear wife is cleaning up health care messes, one patient at a time…