Thursday, April 21, 2011

In the Depths of Medicare

Yes, folks, for those who didn't know, I recently rolled the odometer over the Big Six Five, which means I'm dealing with what starts to look like the weirdest bureaucracy I've ever dealt with.  My situation is complicated because I'm not just going on Medicare - I'm covered under my husband's employee health plan, and I stay on that (regardless of my age) until he retires.  However, before he retires (which will be next month), I had to sign up for Medicare parts A and B - while telling Medicare that I really don't need them yet, thank you.

Getting signed up was relatively simple; then I logged into, and ran into the IEQ (Initial Enrollment Questionnaire), which I tried to fill out on line.  This is where you explain about that employer coverage and its end date.  I got about half way through and ran into a form that required a number I didn't have (our health coverage doesn't have a "group number"), so I couldn't complete it.  And apparently they Really Want You to complete it - I got two successive emails suggesting that I should finish it.  So I phoned them.

I talked to a nice lady who walked me through the remain s of the form, helped me figure out where the information they wanted was, and said, "You're all done."  Great, I thought, thank you very much.  That was about 10 days ago.

Today I got a letter from Medicare.  The cover letter said, we don't have all your information, please fill out the information marked with a double star below and return within 10 days.  What?  Apart from the "attorney's name and address" (I don't have an attorney), it was all information I remembered giving to the nice lady on the phone.  So I phoned them again.

The nice lady I talked to this time said something that totally set me back on my heels.  You don't need to respond to that, she said.  We have all the information, that's just for your confirmation.  But, but - it says, respond within 10 days, I gibbered.  Ignore that, she said; we have all your information that we need.  They should have told you this when they talked to you before.

I logged into and looked at the IEQ online.  It still stopped at the page I couldn't complete.  Do I need to complete the online form, I asked?  It's still not done.  No, she said, it is done, we don't use that system.  (What??)  So I wrote on the cover letter, "ignore this, they have all your information, this is just for the record," with her name and the date; and I filed it.  I shredded the paper questionnaire.

And I've now learned that if you want to deal with Medicare, you have to phone them. It's the only way to get things done; only they understand it....


  1. Which indicates there's a fair bit of streamlining which might be done. Not exactly fraud and abuse, but certainly a bit of waste.

    I'm on the VA Health system, and I've been delighted with the doctors and the care I've gotten so far. Even the admin side has been straightforward.

  2. Oh, certainly some waste and some processes which could work better. But I heard a comment yesterday from someone whose doctor prefers Medicare to all other systems, because when he submits treatment code 1234 for payment, he always gets the same amount of money back from Medicare; which apparently he can't say for any of the other insurance systems...

    And you realize: I'm not on Medicare yet! I won't be on Medicare until June 1, at which time I'll go onto Kaiser Senior Advantage. We'll see how that goes.

    Glad to hear the VA is doing well by you.

  3. Medicine is a business. It isn't a calling, or a duty, or a crusade.

    Prayer doesn't help either.

    If you went to graduate school and did an internship you probably didn't start to earn real money until you were in your late twenties, maybe even later. Most doctors become doctors because they want to be rich, not because they like helping people. Insurance systems are a bitch. Most doctors have to pay more to someone to help them untangle the web of confusion presented by insurance reimbursement than they can make back in the first five months of any given year. And then they have to pay between $175,000 and $450,000 per year just to insure themselves against malpractice.

    Doctors don't like to write anything down. Guess why!

    Doctors are cynical and selfish and greedy. Yup.

    This isn't twenty questions. You don't want to know the really spicy details about medical coverage, because you'd probably commit suicide before submitting yourself for any kind of treatment.

    They don't want you to get better. They just want you to pay, and pay and pay and pay. If you don't have any money, please just disappear, or emigrate to Cuba.