Wednesday, October 20, 2010

A rite of passage and other fun stuff

Guess what?  I go on Medicare next month!  On November 14 I will hit the magic age of 65, when Uncle Sam takes over the bulk of my health care costs.  (Sixty-five????  I am in shock, this is not possible!  Remember when you couldn't wait to get older?  I was so happy to turn 30, thinking I'd finally "arrived" as an untrustworthy adult!  Somehow the current milestone lacks cachet.  I'm no longer looking to "arrive" anywhere any time soon, that's for sure.

It's almost scary, the way Medicare just appears in your life.  A big envelope from the Social Security Administration shows up in your mailbox about 3 months prior to the magic day.  In it are a few boilerplate brochures that purport to explain how it all works, and a flimsy paper thing bigger than any other card you carry, but which happens to be your Medicare card.  The idea momentarily flits through that this is just a sample, that a "real" card, made of plastic with a magnetic strip and that will fit with all your other cards, will be arriving, but no.  This is the actual card which by necessity must be on your person at all times, or at least close by.  If you don't get it laminated or in some other way protect it, it will never last the thirty or so years you intend to use it (if you're lucky). 

The Medicare premium for 2010 is $110 a month.  It will automatically come out of my monthly Social Security payment.  I only net $116 a month from Social Security as it is, since as a career Federal employee the only Social Security-eligible quarters I have come from summer jobs I had when I was a teenager and a few other short-term private-sector occupations I had over the years.  I called to ask if my premium could come out of Federal retirement pension instead, but was told that I had no choice in the matter.  If you get enough in Social Security payments, your premium comes from them.  So, what was once pin money will become--what?  Dust money?  In practical terms, I will not be aware that my bank account is being enriched by a whopping $6 every month.

As the saying goes, they get you coming and going. Under normal economic conditions, Social Security makes a yearly Cost Of Living Adjustment (COLA) to your monthly stipend.  However, the COLA is pegged to inflation, and since OMB has ordained that there has been no inflation for the past two years, there have been no COLAs.  There was none for 2010 and there will be none for 2011.  But that doesn't stop Medicare from upping its premiums.  If I had started with it in 2009, my premium would have been $96 a month and, since there was no COLA for 2010, it would have remained that amount for this year.  But somehow, even though there was no COLA, the premium for 2010 is $110 a month. (If I had any sense at all I'd be sorry I'm not a year older, just so I could have saved $9 a month!)  As long as there is no COLA, my premium will not go over $110, but that is small comfort.

Oh.  And Medicare doesn't cover all of your medical costs.  There are still co-pays and some conditions that are not fully covered, and for those costs, you must have a "supplemental" policy.  The supplemental payment to a provider combined with whatever Medicare pays should make for no out-of-pocket medical expenses on your part.  But the supplemental policies are the same policies that were available to me as a non-Medicare participant, the same array of plans offered under the Federal Employee Health Benefit Plan (FEHBP).  And even though I will be using a plan only to supplement Medicare, thereby reducing my cost to it by a great deal, I get no break on my premiums.  To put it in a nutshell, when you're on Medicare you end up paying at least two premiums--one to Medicare and one to the supplemental plan.  Add to that optional plans, such as "Part D" for prescriptions and separate policies for vision and dental, and you're shelling out more than twice what you were paying just the previous year to keep yourself healthy.  And of course, these private supplemental plans are under no constraint to freeze their premiums because there is no COLA.  Those payments, which like clockwork rise every year, do come out of my retirement pension, which has also not increased in two years for the same "no inflation" reason.  In 2011, therefore, I will realize a net loss in income because of all these new medical costs. If this is progress, give me the Dark Ages.

Don't even get me started about Steve's medical situation, the fact that he is now paying for an individual policy, and I can't get him on my plan because Congress refuses to recognize us legally coupled...


Sam said...

I dread next August (my 65th) - not for the number of candles on the cake, but because of the Medicare/TRICARE-For-Life/Part D nightmare that it brings with it. In fact, I came back into the Army for two reasons: (1) for the monster paycheck - compared to WV public school salaries - to pay down debt, and (2) to put off having to do the SS thing until age 66. That also pretty much maxes me out for SS benefits, so if all goes well, I should be able to retire-retire, as you have Ralph. (You know I'm jealous as hell of that.)

It's all Greek and hocus-pocus to me, a combination of a shell game, ponzi scheme, Amway distributorship, little-man-behind-the-big-curtain, plus smoke and mirrors to me. Somewhere I think there was a good intent that has, alas, gone awry.

We who are fortunate to have at least a few of our wits still with us (I still have half of mine, making me a ... never mind) will be able to figure it out - with help - but God help those who cannot help themselves.

Sam said...

Let me amend that: I came back into the Army mostly because I just can't seem to stay away. It's my heart and soul.

Plus the money, etc.

Ralph said...

Actually, Sam, there's not much to figure out. It's all done for you, literally, it all just "happens," automatically. The only finger you just lift is to notify your primary carrier under FEHB (or in your case TRICARE) that you are going on Medicare and they (primary carrier) will now become the supplemental. They and the genies at Medicare will do the rest. When I first started in on it I was making it much more difficult than it is, trying to change where my payment would come from, etc. There is a system set up and, for better or worse, it works.

You at least have TRICARE, which is a goldmine fully deserved by the armed forces that I wish could be transferred elsewhere. Don't fret. It seems mysterious, but it's not. You're not encouraged to look into the sausage making part of the thing, and I'm OK with that. As long as the sausage is edible, I'm fine.

What I DON'T like, at all, is how "they" can determine there is no inflation while at the same time health premiums continue to rise. And there's not a damn thing you can do about it.

Sam said...

Well, that's certainly reassuring - the "no-brainer" part of this procedure, anyway. I suppose it's necessary to dumb it down, and for some things I WANT them dumbed down so I can understand them - contracts, real estate closings, pension options, etc.

The no-COLA thing is especially pernicious (love that word). It also applies to VA disability payments and military retirement payments - no rise in the CLI, no COLA. As you say, never mind that premiums, rents, cost of gas, etc., continue to rise. Unless it affects the entire spectrum of whatever defines the Cost of Living Index, COLA will not rise.

I wonder if there is such a thing as COLA-Viagra?

Anonymous said...

I couldn't get on Ann's Medicare plan when she started it two years ago. I don't think any married couple is privy to a benefit like that one. I have the VA as you know since bypass surgery but VA will become my supplemental when I turn 65 in three years if I don't die from Cancer first. I never did understand the Federal retirement scheme 10 years being a minimum to collect, I had 9. I get nothing. On the other hand, 6 years drafted for the big fight yields me a small co pay for lifelong medical benefits I can activate for less as I grow older, me at age 57 when I was knocked out of private insurance. If I had waited till 65 it would have been free, no co pay.

Go git em old man!

Ralph said...

Z&M, Ann couldn't get you on here Medicare policy because Medicare doesn't do joint, or family, policies. Every individual American is automatically enrolled in it at age 65. The spousal problem I'm talking about is with the Federal Employees Health Benefits Plan, which covers me now and will until I'm 65. It's the medical insurance that all Federal employees have. It does have spousal coverage, but the federal government doesn't consider Steve and me spouses and it will take an act of Congress for that to change.

Steve's a Vietnam vet and is eligible for VA coverage, but he'd have to go all the way into Virginia to use it, and he'd be pretty low on the totem pole since he's not a combat veteran. The VA remains a fallback if we have to do it.

Lonely Rivers said...

An early happy birthday. I am waiting until my sixty sixth to collect ss and therefore enrollment is not automatic. I sure hope they remember this when I actually do reach the magic 66 as I have heard that it costs more if you miss deadlines..etc.

Ralph said...

LR, if I had known the implications of Medicare upon SS I probably would have waited, too, but as it is I started when I was 62. I have so few quarters that the extra years of waiting would have made no practical difference in my income. But I could have had a few more years of paying just one premium. (But your Medicare premium will be higher!)