IT’S MONDAY! Folks and I hope everyone had a fantastic Thanksgiving. We certainly have some things to give thanks for this year. This week I would like to have a conversation about a subject we are directly involved with currently or will be at some point in the future, and that is Medicare. I hesitate to do this because I am no expert and am not a licensed insurance agent, nor do I propose to know anyone’s particular circumstances. I do feel, however, that some misconceptions are floating around.
We all should know that we are in the midst of the annual sign-up period when we can change our plans based on our wants or needs. I’m sure every person aged 65 and older is currently being deluged with offers in the mail and are sitting through countless tv ads about special benefits for you if you sign up. All those plans are Part C Medicare, and they are really just commercial Insurance. Medicare pays the plan you choose a flat annual fee to provide you with the health care you need. You will be enrolled in a PPO or HMO, and you will be subject to Network limitations, precertification requirements, and more deductibles and co-pays. If you travel and need medical care, you may be out of network and have care denied or be forced to pay higher fees. Remember, the insurance company’s objective is to spend less on you than the government pays them. This is all well and good as long as you are healthy. But as you get older and sicker, the extra charges can become a significant burden.
The alternative to this is to stick with the original Medicare, have Part B deducted from your monthly Social Security payment, and sign up for a Part D prescription plan. To cap it off, get a Medigap or Supplemental policy that will cover or fill the gap for what is not covered. There are several of these, so you need to review them. All this can be a complicated process, so you should seek help to sort out the details. Obviously, the second option will have more out-of-pocket outlays for premium payment, but it is a known quantity, and you won’t get a surprise billing after you have had a procedure or an ambulance ride.
What you can afford is going to be the main factor in the route you take. I am in no way trying to tell you what route to take, but I believe that you should be able to make an informed decision. Slick advertising and celebrity endorsements should not influence your decision. Financial reality and quality of care should.
PARTICIPATE! DONATE! VOTE!
John Huot, JeffDems Chairperson
CALENDAR
Tuesday, Dec 6, 7pm JeffDems Executive Board Zoom meeting, email jeffersoncountypadems@gmail.com if you wish to attend.
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Support your county Democratic committee and send your check to:
Jefferson County Democratic Committee
c/o Jane Halin, Treasurer
PO Box 266
Punxsutawney, PA 15767
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