There has to be an easier way

Published 5:51 pm Friday, October 30, 2015

I don’t even know where to begin to write about my recent experience in getting Medicare supplementary health insurance to begin Jan.1, 2016.

Ever since I retired from the state public employees retirement system, my husband and I have been covered with generous health insurance. Now, since the Affordable Care Act has come into being,  that group coverage is stopping effective Dec. 31, 2015, and we are being forced into signing up for new independent health coverage.

For the past year I have been bombarded with volumes of literature in attempts to explain how the changes will work. They have also graciously established a health reimbursement plan for me for at least one year, that will reimburse me for my premiums incurred, but at the same time they are dropping any help for my husband.

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First, we each had to develop a profile online listing all our doctors, medicines, etc. and lining up an appointment to speak with a representative selected by the retirement system. It was promoted as being someone who would help us through the quagmire of companies and coverages available. We made an appointment to call this person at a prescribed time and were advised to allow one hour to accomplish the task.

The date arrived and I called at 3:45 p.m. as arranged. I had previously read the latest publication that had a short quiz and explanations that were supposed to help me make the right decision. I thought I knew what I wanted, but the first advisor I spoke with had other ideas. I had chosen what I thought was the closest thing to what I previously had, only to be told that I should not take an advantage plan because my doctors might not accept it. Instead I should sign up for a Medicare supplement plan, which didn’t sound nearly as good to me for either the doctors or me. But, what do I know? The health insurance business has gotten completely out-of-hand. If you don’t believe me, just ask the office in any physician or hospital who tries to handle the claims and is expected to know the rules of the multitude of plans available out there.

It is a nightmare!

Well, after spending 30 minutes with the first person picking out what I hope is a good medical and hospital plan, we then had to choose a plan for drug coverage. By this time I am just lost and going along with whatever I’m told. I made a selection. But wait, I’m not through. I am now transferred to the person who will actually handle my applications.  There I must answer a host of confusing questions about my former coverage, why I am now having to enroll, etc. etc. etc.. I was told initially I would not be asked any questions about my medical condition; and I wasn’t directly, but I did have to give my age, height and weight, then wait while he did what he called “calculations.” Apparently I passed that goal as we then progressed to his reading long “disclaimers” full of “legalese” for each policy. They were so long, complicated, and in some ways seemed contradictory as he read them, that I soon was totally confused. But, at the end I was required to swear that I had heard and understood it all. Right! I was allowed to ask for clarifications, which I did, but I did not find them very satisfactory.

So, I hung up after 5 p.m. completely exhausted and unsure of whether I have done the best, right thing or not.

Now, Ron has to go through the whole process, as he cannot be on my policies, as before. He asked me for help in his process. I haven’t a clue what to tell him.

I have always considered myself reasonably intelligent, and was even a licensed insurance agent many years ago, but that was before all the health insurance mania began.

I have to commiserate with any and all who have gone through this procedure of signing up for health insurance. There are definite benefits to having a live insurance professional available to talk with when making these decisions. I did not have that option.

But, on the bright side, my retirement system is helping with the establishment of a health reimbursement plan that will reimburse my premium costs as well as any other “eligible” medical reimbursements for now.

Who knows what will happen after 2016?

I truly believe all persons should have health insurance and that no one should be denied coverage due to pre-existing conditions, but there has to be an easier way.

Life doesn’t have to be so complicated.