It turns out that the average Boomer’s social security check is around $1200 a month [and I am nothing if not average.] With no other income, 48% of the boomer demographic are 100% reliant on their social security.
So I looked into what the government calls the “Medicare Savings Program.” There are ceilings under which some retirees can have their $104.00 Part B premium, all co-pays, and all prescriptions paid for. At $1,216.90 per month (deduct the $104.00 monthly premium from that), I don’t qualify at the $937.00 per month cut-off for that program. But I do qualify to become what’s called a Ql-1 SM-1 Premium Buy-In Only, which means that as long as the sequester/debt ceiling doesn’t queer the deal, I can have my Part B premium paid for. As far as co-pays and prescriptions, I’m on my own.
Before you become dizzy with joy at the thought of the extra $104.00 a month I’ll have to travel the continents, let’s look at Medigap policies. These are licensed by the state, so every state is different, and there is no guarantee that anyone can buy one, at any price. [Well, there’s guaranteed issue in New York, Connecticut and Massachusetts, but all the other states underwrite based on your pre-existing condition(s).]
Why seek a Medigap policy, known widely as Medicare Supplemental Plan F?
It’s a no-brainer, but as of today – in Kentucky – you can’t know (a) if you’ll be accepted or (b) what it will cost, because it’s NOT OPEN ENROLLMENT, stupid.
Come October 15 we can begin to shop. I figure I ‘might’ be able to obtain a gap policy at $131.00. Deduct the $104.00 currently paid and I’ll only be an additional $27.00 a month out of pocket.
But no one can escape the do-nut hole.
Ha, ha, ha!
While the Affordable Care Act has tinkered with the percentage of payments for prescriptions in the do-nut hole, climaxing in a projected year 2020 low, low twenty-five percent (wait, there’s more!), I just saw a hepatologist who recommended a treatment consisting of three drugs over the course of 12 weeks, one of which costs $4,000.00 a pop. I didn’t ask what the other two cost.
But o.k., let’s ration treatment and go for status as a Ql-1 SM-1 Premium Buy-In Only person. For this I have to have a caseworker who must have many documents to prove I am not cheating. Honestly, I have one of the nicest ladies I’ve ever met.
O.K., she’s a little scattered, but who wouldn’t be with the mass of poor, disabled, and/or old huddled at her door? If YOU ever have to manuever this system I advise that you do not mail or fax anything. Like me, be prepared to go in person, wait your mandatory 90 minutes or more until she/he is free, and hand-deliver the information. I suggest casual chit-chat until you see the person actually type in the desired data. After that, you’ve done your best.
Now for the bright side! Under my chosen method of Positive Poverty I qualify for $16.00 a month in food stamps! But wait, there’s more. I also qualify for elderly, low-income housing in which one’s rent can be no more than one-third of one’s income. And for Section 8, though the waiting lists are so long I probably won’t live to see it. AND, much to my surprise, a free, life-line cell phone which a worker signed me up for yesterday.
Applying for housing is a separate process though, so I’m just beginning that. OF COURSE there’s no one-stop integrated social service.
Ya big silly.
Well, I’m off to hand deliver another piece of information to my caseworker.
I leave you with a photo of the August 1971 Womens March on Fifth Avenue for which I was an organizer and, at one point, exhorted the masses from the kick-off stage mic to knock over the wooden barricades halving the street and FILL Fifth Avenue with our demands.
Those demands included universal, single-payer healthcare paid for by taxes exactly as we pay for police, roads, the fire department and other Public Goods. A system in which there would be no Medicare Plans A,B,C,D,E,F, J or Affordable Care Act bronzes, golds, or platinums, or a myriad of Explainers to assist navigation through what is, in my opinion, a deliberately confusing system broken at nearly every level. And that’s if you’re not sick.
My, we were optimistic.