Coffee heat rising

w00t! Medicare to the Rescue!

Damn, but getting old has its perks! Check out this statement from the august Mayo Clinic’s billing department:

Previous Balance: $12,192.40
New Charges: $10,198.49
Payments/Adjustments: $21,645.40
Current Account Balance: $745.49
Insurance Claims Pending: $347.17
Personal Amount Due: $398.32

Medicare has covered the bulk of that, with Medigap coverage from Government Personnel Management picking up the slack. See that amount due? Right now a stack of checks from Medicare and GPM is sitting on my desk. They total a little over $600.

I haven’t received a notice from GPM as to how much they intend to jack up their premiums after this fiasco. The hated Part D carrier, the notoriously evil Wellcare, doubled my premiums by moving me into a pricier level. I assume GPM will do something similar.

The problem with Medigap is that they do underwrite, which means that once you’ve got a diagnosis of a real or potentially serious problem — or had any treatment that cost some insurer a pretty penny — you can’t get coverage with anyone else. Under federal law, your current Medigap insurer isn’t allowed to throw you out, but there’s nothing to stop them from bankrupting you with sky-high premiums.

Part D, however, doesn’t work that way. During open enrollment you can move to other plans. This year I’m picking up Humana’s Walmart plan, whose premiums are only $15/month and whose deductible and copays are much, much lower.

Humana’s reviews are far superior to the evil Wellcare’s, too: five stars for not forcing people to accept drugs that might harm them instead of the prescribed drugs. And four stars — about as high as any of these Part D insurers ever go — for actually filling the prescriptions your doctor asks for. Wellcare has consistently refused to cover most of the drugs my doctors have prescribed over the past four years. Most of the time these days I just tell the pharmacist to give me the bill and not even bother to try to put a claim through, since it’s a waste of her time and mine.

Anyway, it looks like Medicare is going to cover most of the cost of the four surgeries I’ve had so far. Probably I’ll only have to pay a few hundred to a couple thousand bucks. That’s a relief…when I saw that first $11,000 bill, I almost fainted dead away!

Too bad Our Dysfunctional Illustrious Congress couldn’t have gotten its collective head out of its collective you-know-what and simply expanded Medicare coverage to everyone, rather than dorking around with an entire new hopelessly complicated scheme that is hopelessly contaminated by the insurance industry.

3 thoughts on “w00t! Medicare to the Rescue!”

  1. Yes, thank goodness for Medicare! As for expanding Medicare to cover everyone, never thought of it before but sounds good to me.

  2. Thank goodness…We all complain about our health system but it’s times like this that your thankful it’s in place. My Dear Dad gets bills like you describe and after disallowances, discounts and Medicaid coverage, he rarely pays anything.

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