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Su Lum: Slumming

Su Lum
The Aspen Times
Aspen, CO Colorado

When I turned 65, I hied over to Peter Martin Insurance in Basalt to find out what my options were vis-à-vis Medicare. I knew I was automatically covered for Plan A, involving hospitalization, covered by the amount I had paid into the system for over half a century, but I wasn’t sure about Plan B, for things such as doctor visits and outpatient procedures, which most them are these days.

Peter Martin looked over my Aspen Times health insurance policy, immediately advised me that it was much better than Medicare and told me to hang onto it as long as I could, which is exactly what I did until The Aspen Times management informed me that due to cost-cutting (and I’m talking to the BONE, no more free Kleenex to pass out during the sackings) and my part-time status, I had to change to Medicare and, P.S., I had two weeks to do it because there was a March 31 deadline.

It had not escaped my notice that, in the years since I had turned 65, our various health insurance policies with the newspaper had gotten more expensive and restrictive. Even in the most expensive choice of plan, we paid $3,000 put of pocket before full benefits kicked in, and I had another $3,000 taken out of my paycheck to cover the prescription non-deductibles and things like eyeglasses and hearing aids, which are not covered. What I didn’t know was that Medicare reforms over the years had made that option a lot more attractive.

With the time clock running, I dashed back to Peter Martin’s office, where I talked with David Harding, a local guitarist of considerable talent and fame now moonlighting in the insurance biz, who outlined the somewhat complicated process of enrollment.

First, I had to get enrolled in Medicare’s Plan B, requiring a phone call to the Glenwood Social Security office, where the line is constantly busy. Once I got through, it was pretty simple: The lady faxed me a couple of surprisingly minimal forms to sign.

I expected to be socked on the cost for Plan B because there are mounting penalties for not signing up when you come of age, but it turned out that since I had been covered by my work insurance all that time I was exempt! This was looking better and better.

For Plan B (which I think of as “other” but have yet to determine what it really covers), David suggested a Mutual of Omaha policy (didn’t they sponsor those fake animal shows on TV?), which cost approximately what I had been paying for coverage through the Times. David handled that part.

More good news was that although I am a living, breathing pre-existing condition, I did not have to divulge any health history whatsoever!

David then offered to walk me through the second phase, prescription coverage through Humana, which involved inputting all of my meds and getting a read-out showing what the best plan for me would be, but I was running late and said I could do it online, hearty har.

The long and short of it was that I traveled the world on the telephone for the next few days, with long detours to India with neither party having the faintest idea what was being said by the other, almost signed up for a policy I didn’t need or want but was, fortunately, too stupid to finalize (and then kept getting plaintive e-mails), finally completed the correct application online only to be told I wasn’t eligible because I wasn’t signed up for Plan B (I WAS!) and ended up on the phone for over an hour with a young man reading aloud every last word of the policy, intermittently asking me if I understood what he had just said. It was like Kathryn Koch reading our city ordinances. He made it clear that Yes or No were the only acceptable answers, so I kept my smart-ass remarks to myself.

That was a couple of weeks ago, and the mail has been flying in. I received my magic Social Security, Omaha and Humana cards, and fat explanatory manuals from both companies. I filled prescriptions at Carl’s that I had run out of with Express Scripts (the less said about the better) under my Times policy, one of which (Advair inhaler) cost $243 and another cost $1.22, a discrepancy which may or may not have involved an initial $350 deductible.

I used to think I’d have to die at my desk, hanging onto my health insurance lest I get kicked out of the system entirely or have to pay through the nose for catastrophic coverage and my pre-existings. I’ll report back later when I know more, but right now it’s looking good.


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