Sometimes you see the ball coming but just can’t get out of the way and other times it is a curve ball you didn’t expect to hit you in the head or in my case the lungs. I do not know why I am using the metaphor of baseball. I could never hit the ball. Running to a base usually triggered my asthma. So why the metaphor? It sounds more clever then life can be difficult and unexpected or just when you think you nailed it; BAM!, you missed! One thing I know for sure life is always changing. We are all born dying, some just take a little more time to make it to that home base. Enough with baseball!
Turning 65
The Fun Part
My 65th birthday was my GOAT birthday, the Greatest of All Times, GOAT. Four of our children and their familes along with a sister to my son traveled home to North Dakota. We met at Fort Stevenson State Park about an hour from where we lived. We rented three cabins . Besides swimming, a favorite activitiy of mine is going out on the water on a pontoon.
You cant have a “Goat” birthday without goats! The Indian Hills Resort along North Dakota’s beautiful Lake Sakakawea is a favorite spot for us to rent a pontoon. Love all the different shoreline topography and of course, Goat Island.
Not so fun, Medicare and the Social Security mind field
Our system of Medicare and Social Security is what it is. There are not enough words and paper to write how I feel changes could and should be made to our health insurance system and retirement or disability system.
If you are forunate enough to stay in the game of life till you are 65 you will need to migrate applying for Medicare and supplements for your health insurance you will need in your golden years. The choices are many and over whelming! I think I am pretty savvy in problem solving but navigating the system because it is so foreign is easy to give up or give in and do nothing or something or maybe make a good choice for yourself.
My journey in the Medicare Mind field
Go to Medicare website find out what Medicare A and B covers
Then you will have to decide on a supplement plan or as the Medicare website calls it a Medigap plan which is A-D, F, G, and K-N. Price is the only difference between plans with the same letter that are sold by different insurance companies. This is where it gets tricky every state has a list of approved providers. As mentioned above the only difference in these plans is the companies selling, the PRICE! Part C Advantage plans may have more perks, but have certain things required of them. For me how do you decide on which company if the Plan G is the same from all of them?
For those in their golden years looking at signing up for Medicare supplements or advantage plans you may be getting bombarded with phone calls or flyers in the mail. What plan is the best?
This is what I found out:
A supplement (medi-gap) pays the out of pocket expenses which Medicare Part A and B do not cover. These supplements are purchased through a insurance company licensed to do business in your state. It is important in North Dakota the individual agent is licensed. You can double check (don’t just take their word they are) by calling the North Dakota State Insurance department +1 (701) 328-2440 or your state department. This phone call can be invaluable and so helpful wading through all the insurance companies. Biggest take away is all the lettered Medigap, Plans offered (A-D, F, G, and K-N) by insurance companies are required by law to be the same across all companies, the difference will be in their customer service, monthly cost, rating and any discounts they offer. First decide on your plan, plan G will probably be the most expensive but provide the most coverage and cover deductibles (think catastrophic events like a stroke or heart attack) Again your state insurance department could be super helpful and provide a list and pricing companies providing the plan you want and the price. North Dakota sent out a list of companies for the Plan requested. So helpful. I found the phone call was easier then the Medicare website.
Advantage Plans Part C of Medicare
So you may decide a more inclusive plan that is called an advantage plan which is referred to as Plan C, the majority of people are going with this because the monthly costs are very affordable and cover vision, dental, offer other perks. This is all fine and dandy if you never will need a doctor outside your state, out of the country or have a chronic condition, such as asthma, diabetes, heart disease, cancer or other chronic conditions. So these are the plans you will see advertise, pushed by sales reps, free meals to attend a seminar. They are also the plans that will cover things like Silver Sneakers, eye doctors and dental which is a popular selling feature for the insurance company but could be the trade off for not being covered if you have something catastrophe like a stroke or heart attack. You still need to do you homework or you may be the unfornuate one who ends up with low monthly premiums but have a stroke or heart attack while you are wintering in another state and boom the medical bills pile up because you are not covered under the advantage plan. Just recently a news report has reported that Hospitals and Doctors are having claims repeatedly denied. So just like you have to play to be a good ball player (that metaphor again) you need to do your homework. Remember in some states once you select a Plan C you can not get Plan G that offers more coverage.
My experience almost a year later
We went with Plan F offered only to Railroad Retirees or the next would have been Plan G. I have been hospitalized more then my mother-in-law who is 95 and has been hospitalized only a handful of times in her lifetime. She rolled the diced and went with an advantage plan, it covered most everything until she had a heart attack, now she has more medical bills. I signed up as soon as I could before turning 65 years old for Part D, little did I know I would require a drug that I could not have known I would need when I enrolled and when my birthday of 65 years old hit. Needing this drug I could not change my part D till the next open enrollment period. OH CRAP! that was an expensive choice.
Breathless
I have had asthma all my life. Maybe the trip to a higher elevation then Denver, Las Vegas not Nevada the other Las Vegas, New Mexico. Maybe the little virus I picked up, it wasn’t Covid or maybe allergies? Whatever caused me to be breathless landed me in the ICU in another state with acute respiratory failure . Or maybe it was that darn movie I saw that day, left me breathless. I joked at the ER,the movie took my breath away. The movie, Magic Mike’s Last Dance with all those hot dancers. It was more of a love story. Defintely entertaining but it was probably NOT the cause of me struggling to catch my breath
Wishing I knew then what I know NOW
The perscription cost $1000 to help me breath again for one month without insurance. Why no prescription drug insurance? My husband turned 65 first leaving me without drug coverage. I had rolled the dice and took the chance of having no perscription coverage from February to June until my part D would kick in. I had GoodRX which is a FREE program which brought it down to $649 for one month. When my Part D kicked in almost 3 months later it went to $625 for one month. Shocking to me as I have lived a sheltered insurance life. Paying $1.66 a month for any drug with our employee plan did not prepare me for this sticker shock. This is where my eyes became wide open I tried to check drug prices while on Part D and if you can get a quote they are all over the place. Then they start talking about drugs being in different Tiers and those higher Tiered drugs will throw you into a donut hole and wipe out savings faster then you can say glazed or sprinkles!!
A Perscription alternative
Belonging to a private Facebook group by AARP for women over 50, the Ethel Circle. In desperation, I asked: “What can I do?” Who can afford a drug that is almost have a my income for the month supposedly with insurance? Our household income did not qualify us for any help from the drug company nor government programs. So some suggest getting the medication but no one said how you do that? Do you drive to Canada? Is it legal?
In desperation I googled buying perscriptions in Canada. It is legal as long as the drug is FDA approved in the United States. I figured driving there, we live only 2 hours away from the Candian border, would be cheaper than paying for that one drug here. No need to travel to Canada, just make a phone call then have the perscription transferred from your local pharamacy. Filling mine cost only $294 and it was for a 6 month supply! Canada Online Health is the place to get affordable perscriptions even if you have Part D. With open Medicare enrollment period Oct. 15 – Dec. 7, I waited closer to December in case I have any weird health episodes pop up, needing another expensive drug. No new drugs and the expensive one I am no longer in need. So I chose a new plan D that supposedly will cover if I need that expensive drug in the future again.
The cost of Healthcare in the USA sucks
It is not just turning 65 that presents challenges for affordable healthcare. As a self-employed person under 65 it can be a real nightmare. My friend Stacy has survived ovarian cancer but still needs medicine and a surgery to keep her “line” to kidneys open. Please help her out. This is something she needs for her lifetime, to live. It was so irritating to read that she needed money up front besides her insurance to have this life saving procedure done. Ridiculous that we need to use Go Fund Me accounts to finance something to stay alive. Here is the Go Fund page I created to help her : Stacy Go Fund Page
Another Sue B
Sue is a fantastic writer, baker, grandma and a wonderful person. Following her blog and reading it is like a cliff hanger and you want to get to the last entry where the outcome is a happy one. What has happened? In January she was thrown a curve ball. She once was our editor of our local paper the Mandan News, more like she was the editor, the reporter, the photographer and the person who laid out the paper, she did everything. Many of times she published my “Letters to the Editor”. My older children and her children are about the same age, and knew each other from school. She recently retired from her job at a local Lutheran church concentrating on her massive garden, baking , serving on several boards and of course writing. A blog post in August caught my attention in August and since then I have been following the story or the journey more out of twilight zone then “a curve ball”. It is worth a read, the story starts with this entry on her blog: https://indychildren.blog/2023/08/20/the-truth-comes-out-in-february-2023/
Going to a warm weather helps my health please check out Snowbirding
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