I Apply for Medicare, Part II

     The other day I received an envelope in the mail from the Social Security Administration. I opened it up. I got my Medicare card!

     I feel like I've been accepted into an exclusive club. Better than AAA; better than AARP; better than my America the Beautiful senior pass to the National Parks.

     Now, if I only knew what Medicare covers. And what other medical coverage I should get.

     I went through one round of trying to figure out how Medicare works, apart from Parts A and B, as I recounted in I Apply for Medicare, Part I. I did learn some information; but not enough to make me think I could find an appropriate backup plan.

     So I phoned my sister. She's older than I am and has been on Medicare for a couple of years -- and I know she's used the system, so I thought I could ask her how it works.

     "You haven't gotten any information in the mail?" she said, incredulously. "I think I got several mailings. But to tell you the truth, I wasn't paying attention." She knew she was going on her husband's medical plan to supplement Medicare. It's a good plan and, as she said, "It's almost free," and so she didn't research other options. Some people are lucky. And she was happy getting whatever she would get.

     My ex-wife had mentioned that she'd gone to an insurance agent specializing in Medicare plans. The agent had assessed her situation, come up with several options for her and explained the details of both coverage and cost. I googled Medicare insurance agents in my town. The nearest one is a 40-minute drive. Maybe I'd go see him, I said to myself, but let me try to figure this out on my own. I really didn't want to have to drive that far, on speculation that the agent would know what he was talking about, and know what would be best for me.

     Of course, I'd neglected to ask my ex-wife what plan she'd decided on. So I called her back. She told me she's using a United Health Care plan she got through AARP. That was the one recommended to her by her agent; and so far it was working just fine.

     Meanwhile, I'd received two thick envelopes from my own insurance company. I opened them up; and the contents were both intimidating, and discouraging. Oh man, I really didn't want to read all that mumbo jumbo!

     Nevertheless, I gamely opened up the package and started to read through the material. There were several HMO plans. But I want to reserve the option to go to a doctor outside my network, in case I ever need a certain specialist. So I turned to the PPO plans.

     I tried to compare PPO I and PPO II and PPO III and PPO "High Option." I focused on PPO II and PPO III, figuring I didn't want either the cheapest or the most expensive plan. But it looked to me, as I inspected the columns of benefits, that PPO III is more expensive but offers fewer benefits. That couldn't possibly be right. So I threw up my hands and gave up. For the moment, anyway. I knew I'd have to go back to it.

     Then I thought, I should contact AARP. If it was good enough for my ex-wife, it would probably be good enough for me,

     I went to the AARP website. After searching through the site (the insurance plans are hard to find) I found a reference to several AARP Supplemental plans. And I also found a recommendation for Medicare Advantage plan. What's the difference between Medicare Supplement, and Medicare Advantage? I didn't know. I'd also seen reference to Medicare Gap plans. What are they?

     I decided to call the 800 number. I then spent about 45 minutes on the phone with a woman who explained all about the AARP Medicare Advantage plan that was available in my area. There are several advantages, she explained. It takes the place of Medicare Part C. It includes the Part D drug plan and some dental insurance and some other ancillary benefits.

     Then she finally allowed as how the Medicare Advantage plan is an HMO plan. "Oh," I said. "That means I have to stay in a network?"

     "Yes, that's right. But we have a lot of doctors in the network."

     "Wait a second," I said, as it finally dawned on me. "Are all Medicare Advantage plans HMO plans?"

     "Yes, that's right."

     "So how can I tell if my medical group accepts this AARP Medical Advantage plan?"

     "Oh, I can look it up for you."

     So she put me on hold for a minute. She came back on the line. It turns out my medical group accepts several other United Health Care options. But not this United Health Care Medical Advantage plan. So unless I changed to another doctor in their network, every time I went to the doctor it would be out of network, costing me a fortune.

     Were there any other options available to me? I wondered. What about that AARP Supplemental plan I saw on another page of the website?

     "Oh, I don't handle those plans," said the woman. "They're administered through someone else."

     So . . . 45 minutes down the drain. But at least I learned that a Medical Advantage plan is an HMO plan, requiring you to go to doctors in their network.

     I was drained. No more research today. I quit . . . knowing no more than I knew before -- which is that it is easy to sign up for Medicare, but hard to find out exactly what you're signing up for. But I will figure it out, for sure, for my third and final installment of how I applied for Medicare, coming up (hopefully) next week.