Baby Tulip Popular in the flower bed, 2014
Yesterday, a message (a reply) to something I wrote in response to GigiHawaii’s post on Future Plans popped up on my iPad. Because it was so rude, at first I thought it was spam. The issue under discussion in Gigi’s post involved Medicare. The topic was Medicare Advantage plans and their availability. The responder accused me of being old and confused, both of which may be true at times. She ended by saying I was spreading lies. I may be older and confused at times, but I cannot be lying if I am confused…I think. I am sitting here with Medicare and You, 2015, the latest volume (“brochure”?) from the Center for Medicare and Medicaid Services distributed to help us old and confused people understand what our medical coverage will be like in 2015.
Because the current administration keeps delaying the full implementation of the ACA, many of us are more confused than ever. The Pharmacos and insurance companies try to stay ahead of the situation, and in our case send us much anticipatory printed material. Last year, they sent David a message informing him that owing to changes in the law, they would be making changes in his coverage.
This year these changes have materialized as larger co-pays. For example, although I take twice as much of a certain drug as David over a 90 day period (2 pills per day), my total co-pay for a 90-day supply is the same as his co-pay for a 30-day supply of one pill per day. I have other examples, regarding visits to doctors where he always has an out-of-pocket co-pay, and my insurance fully covers my co-pay.
I retained the insurance policy I carried while I was working for the federal government, but David has a United Health insurance policy he earned through his thirty years with AT&T. I pay a monthly premium for my health care insurance, he pays nothing but a premium for dental care. I have minimal dental coverage.
In addition, I have traditional Medicare, Part B, and he has a Medicare Advantage plan. We both pay the Part B premium.
I had David on my plan until I retired and I was on his plan until I retired.
When I went on Medicare Part B, I decided after hours spent speaking with a representative or two or three at CMS, his plan representative (United Health), and my plan representative (BC/BS), to remove myself from his medical plan and drop him from my medical plan…mostly because the former confused me about my medical expenses and the latter doubled my insurance premium.
I could go on and on with this, but suffice it today, that the only thing I can deduce is that although I made careful plans for our future health care expenses, external forces are at work. In David’s case at least, the changes his insurers are making are attributed to changes in the federal law. I deduce that to preserve their bottom line, companies are making changes anticipating what is yet to come when the ACA is fully implemented.
I won’t expound on this here, but my SIL, who runs a small business and who tries to retain health care for his workers and their families, has seen insurance company after insurance company drop out of the market in response to the ACA. He predicts that eventually, two mega-corporations will own the insurance market. Those companies will be United Health Care and Blue Cross. So fasten your seat belts, you may be in for a bumpy ride.
Regarding yesterday’s puzzle. The tree is a Tulip Popular, so-called because its leaf and flower are reminiscent of the bulb flower. At 60+ feet it is the tallest and straightest tree in Eastern U.S. climax forests. It is also a native tree. Look for the leaf near the center of the photo.