Medicare Anyone?

Well now, I've spent most of my time these past few months navigating Medicare, Apple Health Medicaid/Classic Medicaid, DSHS and Social Security. I didn't enter this complicated world by choice. When I originally became disabled I couldn't get health insurance (I worked as a contractor and I had a pre-existing condition: I'm a Hodgkins cancer survivor!). Then, in 2013, the Affordable Healthcare Act was implemented and, thank you voters and congress, I got health insurance through Washington's Apple Health (Medicaid) program. I've felt so very humble to have had my medical expenses 100% covered during a time in my life when it was needed as a matter of life and death. Unfortunately, the Apple Health program only provides two years of coverage. Last December, I received notice I was automatically enrolled in Medicare, effective April 1, 2016. That initiated learning about "all things Medicare" and choosing what kind of coverage would be best for my transplant situation. Becoming educated about Medicare takes an incredible amount of time reading and making phone calls, which includes hours spent on hold with agency after agency. It involves visits to advisors and sorting good input from misinformation. I can finally surface for a breath of air! I find it very frustrating that services so necessary are so very complicated. I consider myself to have my wits about me and have enough education to be my own advocate. I'm also blessed to have the assistance of my daughter, Stacy. It breaks my heart to think of people who can't maneuver through these systems.

Whew! At this point I've obtained a Medicare Advantage Plan - United Healthcare's AARP Medicare Complete Plan 1. I think it's really neat to find the "seniors organization AARP" actually endorses credible plans! It's an HMO with it's own network of providers and formulary of drugs it will cover. What's the glitch? There has to be one right? Well, yes...my insurance is effective now. But, I haven't been able to find a primary care provider (PCP) who can see me as a new patient in a timely fashion. To shorten a long story: I called a medical clinic of providers for an appointment and they're so backed up the gal who schedules Medicare patients will call me in 8 to 10 days to get me on their calendar. I've been advised that most of their doctors are booking 3 months out. I do have a Plan B in the works folks! The family doctor I've been using for the past two years, in a different medical facility, wants to remain my physician. She accepts my insurance. Unfortunately, there's some kind of administrative glitch happening such that their contract has to be renegotiated yada...yada...yada... Whichever works out first is the doctor I'll use moving forward. In the interim, I can only go to the emergency room if I'm in need as I don't have a PCP to see me or provide referrals. My oxygen company promises they will continue service in anticipation of having continued insurance coverage. I shudder to think of living in a hospital if I couldn't get oxygen delivered at home...argh!

I've also submitted applications for the Medicare Savings Plan (help paying premium, copays, etc.) and Extra Help (help paying perscription drug costs). I was advised the Extra Help application can take 60 days to process because the IRS is slow providing information they request. Keep up the good thoughts for me please! I'm shocked at how much the perscriptions I have now will cost if I don't obtain assistance. Well, let's just say I sure won't be taking some of them much longer unless help comes in some way, shape, or form. It's really rather frightening to realize the costs for drugs after transplant will be a lot more...

For now I won't hit the panic button! Instead, I'm grateful Medicare exists in any form. If approvals and referrals don't happen in a timely fashion there is nothing to do but deal with each day as it happens.