Health Insurance: How Ya Doin'?

I recently had a conversation with my favorite Aunt who is in her mid-sixties, and she updated me on the "health insurance hell" she has recently been enduring. 

Her existing insurance provider, which she purchased on her own, out of pocket, decided to drop her.

She doesn't qualify for Medicaid.

She isn't ready to accept Social Security retirement yet, so she doesn't qualify for Medicare. 

So, her only option appears to be utilizing the state health insurance exchange.  Or, go without health insurance and face a penalty, which would be a risky move.

In the process she is required to get herself NOT qualified, so she has had to divulge all of her intimate financial information and prove she is in fact a citizen of the United States (with more copies of intimate information).  She has spent hours on the telephone, had several face to face meetings, not to mention making a mess of her important files (which adds more stress).  This has literally become a part time job for her because, of course, there are deadlines.

And she isn't even done yet. 

Her frustration oozes through to me and I don't know what to say, except to email her a link for a little bit of comic relief: 
http://www.theblaze.com/stories/2013/10/27/you-will-probably-want-to-see-this-saturday-night-live-skit-mocking-the-obamacare-website/

Fun with Medicare.gov

I was recently asked “what does the new health bill mean for me as a Medicare participant?”

Anyone who deals with Medicare knows that is a loaded question!

So, I set out to better inform myself. On the Medicare.gov website I found a message from Kathleen Sebelius who is the Secretary of Health & Human Services, the group that oversees Medicare.

What I repeatedly found was the following statement: “Your guaranteed Medicare benefits wont change - whether you get them through Original Medicare or a Medicare Advantage plan”.

My question is: What are “guaranteed Medicare benefits”?
I did a search of the term on the Medicare.gov site and was referred to several publications that used the term, but that did not define exactly what they were. I did a general search with my internet browser - surely these guaranteed benefits are outlined and published somewhere. I was again referred to the publications that used the term, but did not define them.

Back to the drawing board. I did a search for “Original Medicare” since that plan has “guaranteed Medicare benefits”. I was given a “Your Medicare Coverage” page and discovered Original Medicare is sometimes referred to as “fee-for-service”. I also discovered this statement: “It is important for you to understand that Medicare does not cover everything, and it does not pay the total cost for most services or supplies that are covered”.

But wait! There was a “Note”: If you belong to a Medicare Advantage plan….you may have extra benefits, like coverage for prescription drugs or extra days in the hospital.”

So then I referred back to Kathleen’s message and what she said about Improvements to Medicare Advantage. “Today, Medicare pays Medicare Advantage insurance companies over $1,000 more per person ….than Original Medicare” and then the mystery statement again: “...you will still receive guaranteed Medicare benefits”.

Confused? Me too. What I do know is that Medicare Part A helps cover hospital/skilled nursing expenses. Medicare Part B helps cover doctor, outpatient and some preventative services. Medicare Part D helps cover the cost of prescription drugs.

As a former Medicare provider, we know that Medicare can be fickle when issuing payment for certain items listed as covered under A, B or D. There is no guarantee they will cover anything.

I think we will all have to wait and see what this new bill means for Medicare participants.