As I described over three previous posts -- summarized in Tips for Enrolling in Medicare -- I recently signed up for Medicare.
I never had to try to sign up for Obamacare. I've been spared that exercise because I became eligible for Medicare just in time.
Before Medicare, I had my own medical insurance that I purchased through a professional association I belonged to. That's one of the several problems the Affordable Care Act promises to solve: Until recently it was breathtakingly expensive for early retirees to buy individual health insurance ... if they could get it at all. When I left work and had to get my own health insurance, I could not find an insurance company that would carry me. The only way I got coverage was to search around and find an association I was eligible to join, then purchase a plan through the group. It still was expensive, but at least I was able to get it.
Anyway, a couple of months ago, I signed up for Medicare, along with the AARP Medicare Supplement plan through United Healthcare. But, like many people, I didn't really know what I was getting into. Who reads all that material they send you?
So I'm here to report some preliminary results -- not on how much it costs, but on what benefits you get.
I went for my annual physical a few weeks ago. It was free (to me anyway), just like my old plan. I received a flu shot, also for free, just like my old plan.
Subsequent to that, I had to fill a prescription -- nothing that resulted from my physical, but a drug I've been taking on occasion for the past year or so. How do I say this? It's a performance-enhancing drug, if you get my drift. I'm not embarrassed about it. After all, women use plenty of cremes and lotions and "estra-fem" type products. So why can't men take advantage of modern medicine for their own issues? Anyway, my old private insurance plan offered a modest discount for a bottle of six pills. It cost around $140. However, the AARP drug plan did not cover the drug at all. The same prescription cost me $194 ... which seems ridiculous, but what are you gonna do? Maybe the AARP plan doesn't cover this drug because the issue doesn't come up that often among elderly Medicare patients?
Anyway, for almost two months, I've been suffering a terrible cough, with some mild pain in my chest. I actually told my doctor about it during my physical. He was not concerned; he said it might be a touch of post-nasal drip, or else a bit of acid reflux. He suggested a couple of over-the-counter remedies.
Over the past three weeks it got worse, until it finally broke out into what seemed like a cold. Except I didn't get a stuffy nose, just a horrible sore throat and congestion in my throat, and a cough that wouldn't let me get to sleep at night without taking something like Benadryl or NyQuil.
So I finally decided to go back to the doctor. Saw him on Tuesday. Did I have a copay? I asked. No copay, I was told. My old plan would have required me to pay $35.
The doctor measured the oxygen in my blood and listened to my chest and peered into my throat. His conclusion: my lungs are fine; I have post-nasal drip, aggravated by the change of season, the dry air and possibly a slight infection.
But the point is, he prescribed two items for me. One is an antibiotic. The Medicare drug plan paid a portion of the bill. I paid the rest, which was $10. He also prescribed a special cough suppressant. The Medicare drug plan did not cover that at all. Cost to me: $25.
So what am I to make of my new Medicare plan? It may be too early to tell, but preliminary results say that the coverage for doctor visits is very good, but the drug coverage leaves a lot to be desired. Does this square with other people's experiences? I guess I'll find out more as time goes on.