Your ’Care Package


By Neil Offen

Like many of us of a certain age, I thought enrolling in Medicare would be easy. I figured I’d have to prove I was 65 by remembering who the Captain and Tenille were, but then I’d automatically be covered because that was the American Way.

Well, the American Way, apparently, has a number of tolls, along with dangerous curves up ahead and not a single clean rest stop. Medicare, similarly, has many different parts and also not a single clean rest stop.

I’ll explain, for those of you already enrolled and hopelessly confused and for those of you who are younger and looking forward to being hopelessly confused.

Medicare is divided into parts. The first part is Part A and sometimes Part B. Then there’s the party of the second part, which is Part C and Part D. Altogether, sort of, these parts are colloquially called “Original Medicare.” Because, why not?

Medicare Part A is essentially hospital insurance. You insure the hospital you won’t go there often. If you appear too frequently, you pay full price for one surgery but at least get the second one 50% off.

Medicare Part B covers certain doctors’ services, but only ones you will never need.

Medicare Part A doesn’t cost anything, which is probably why it doesn’t cover much of anything. You actually pay for Part B, with your premium set each year by a group of actuaries bored with playing fantasy football.

Then there’s Medicare Part C. Well, technically, there is no Medicare Part C.

It’s just called Part C, sometimes, to mystify us, in case we weren’t already eating our soup with a fork. Part C is usually called a Medicare Advantage Plan. Advantage plans are offered by a private insurer that has made a sweetheart deal with Medicare, which was too busy writing confusing enrollment guidelines to pay attention.

Designed to make up the difference between what Medicare pays and what the federal deficit is, an advantage plan provides all the Part A and Part B benefits, plus a side of fries. Most also provide Medicare Part D benefits, which is prescription drug coverage because it would have been too simple to call it Medicare prescription benefits.

There’s also a Dual Complete Plan, which is like an advantage plan but may be entirely different or the exact same thing under a different name because health insurance companies want to keep us on our toes.

These plans cover 20% of this and 35% of that or 100% of something else (after the first 35%) and 60% of the second 25%, minus the 18% co-pay, for days 1-6 if you are an in-patient and can read the third line of the eye chart. Assuming, of course, you are in-network.

Then there’s a Medicare Supplement Plan, which is different from a Medicare Advantage Plan because it does not include Plan D prescription coverage but does include everything else and doesn’t make you pay co-pays after you meet your deductible, which you do via Zoom or through e-Harmony. A Medicare Supplement Plan is also sometimes called a Medigap Plan in a largely successful effort to engender migraine headaches.

If you get a supplement plan, you will have to get a separate Part D prescription plan, but there may be none left because you have taken so much time figuring out all the previous parts.

Many different private insurance companies offer these supplement plans. Each company tells you its supplement plan is better than every other insurance company’s supplement plan. In fact, they are all exactly the same because the government requires them to be the same but will slap them upside the head if they tell you that.

If you are confused by all this, and also don’t understand that your plan also will depend on where you live, how old you are and if you are still breathing, be comforted by the fact that you have made the insurance companies very happy.

Carrboro resident Neil Offen has written humor pieces for a number of different publications, in a number of different countries. His column appears twice monthly in The Local Reporter.

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2 Comments on "Your ’Care Package"

  1. Kerry-Ann da Costa | November 17, 2022 at 8:53 pm | Reply

    really enjoy your columns

  2. Then, of course, we have Medicare Advantage which is run by private for-profit corporations and the plain old Medicare of years past. Medicare Advantage will set you up with a free gym membership, but will deny you coverage if you really get sick, so it should be called Medicare dis-Advantage.

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