My experience with Medicare, Peggy's attempts to get Obamacare


First Medicare

I’m about to start my second year on Medicare (the US government's healthcare insurance program for the disabled and people over 65), and I’ve learned two things. One is that I love my Medicare Supplement insurer—State Mutual of Georgia—and the second is that I loathe my Medicare drug insurer—Humana—and its lame-ass online pharmacy, RightSource. I just switched my drug insurer to Express Scripts, which has the highest customer satisfaction rating of any stand-alone drug provider, and, like Humana, has its own pharmacy. After what I pay for my four prescriptions is figured in, I’ll come out cheaper paying Express Scripts $55.90 a month instead of the $12.80 that I’m currently paying Humana. My total Medicare insurance costs for 2015 will come to $3,500. Medicare is what happens when the government takes what should be an easy to understand insurance program and throws it to the wolves, that is to the private insurers that hide the true cost to consumers behind a wall of options, legalese, and acronyms. It is not for the good of the individual that scores of companies offer scores of impossible to compare plans.

I started Medicare two months after breaking my back last November. I had plenty of time on my hands, so I began to study my Medicare options in the na├»ve belief that it would be fun and interesting, but it turned out to be a nightmare, the understanding of which would require a team of lawyers to evaluate and compare 120 page insurance contracts, one after another after another. This is why most people buy their Medicare policies from private agents. The downside of doing this is that these agents are themselves largely ignorant, and their primary goal isn’t to help the consumer but to make money by selling the policies of the very few companies that they represent. It’s also true that not all insurance companies sell through agents, and those that don’t can offer better prices because they don’t have to pay commissions. State Mutual of Georgia is one of them. You either buy from them yourself or not at all.

Dealing with Humana’s pharmacy—RightSource—is so bad that I would qualify it as abusive. The policyholder part of its website is all but undecipherable, and filling every order for every drug is so time-consuming and tedious that I never know if I will ever receive my order, but certainly not in less than three weeks. RightSource is such a joke that I have come to wonder if it's in Humana’s interest to deprive customers of their drugs. After it repeatedly “lost” or delayed order after order placed by my friend, Walt, on the behalf of his senile parents, Walt stopped even trying to use his parents’ insurance, and started paying the full costs for their drugs himself. The last straw for me came when someone at UPS stole my monthly order of oxycodone, and RightSource took it out on me by refusing to ever again ship me oxycodone. They knew the loss wasn't my fault, but they simply didn't want to be bothered with trying to ship narcotics to someone who had had a problem receiving them.

Obamacare, aka The Affordable Care Act

As tedious as Medicare is, it’s a hell of a lot better than what most people have. Unfortunately, Peggy is 63, and she can’t start Medicare until she is 65. Since she recently retired, she will hopefully go on Obamacare, which, like Medicare, is a government program that is run by private insurers. She initially tried to go on Obamacare when she retired this summer, and to this end, I (being the one who handles her business) registered her with Obamacare in March, but even though I started five months early, I still couldn’t get her a policy before she retired. This was due to the failure of Oregon’s Obamacare website whose creators are now being scrutinized by the feds to discover how all those millions could disappear without anything but an unusable website to show for it. Because she couldn’t get on Obamacare when she first retired, she bought a catastrophic insurance policy that is nonrenewable and expires on December 31.

Applications for Obamacare for next year opened on November 15, and I started an application for her on the national site on the 18th. No sooner had I set a username and password than I was locked out of the account that I had just created. I called their toll-free number, and an agent spent a couple of hours trying unsuccessfully to fix the problem. I spent many more hours over the next two days talking to different agents without ever getting logged-on. The last agent gave up, and said he would fill out the form himself and snail mail it to me. I didn’t see how this would enable us to buy a policy when we couldn’t even compare the policies (when I try to look at them online, all I get is six blank pages with the following words at the top of the first page: “Here are your 59 policy options”), but it seemed better than nothing. He was almost through with filling out the fairly long form when the software reloaded and all of Peggy's information was deleted.

I finally tried to create a whole new account for Peggy by using another email address, and this seemed to work, but when I tried to finish filling out the required form, the pages wouldn’t load. This has happened everyday since, so I haven’t been able to finish setting up her account, and I still can’t see the policy options, something that I should be able to do without having an account.

This is but a tiny taste of the state of insurance in America. If you work for a big company, you probably have insurance unless that big company is a franchise like McDonalds in which case you have no insurance; you don’t make enough to buy insurance; and the taxpayer is left to pay your medical bills through a program for the impoverished called Medicaid. On the other hand, if you’re disabled or over 65, you probably have Medicare. If you're not insured at work, or impoverished, or old or disabled, your insurance policy consists of hoping to god you don’t get sick because, unless you’re rich, you’re going to wind-up in bankruptcy court if you do. No matter how long and hard most people work or how much they save, few people can stay solvent when they’re too disabled to continue working, and they owe a half-million or more in medical bills, medical bills being the leading cause of bankruptcy in America. Obama promised to put an end to all that, but the dumb-fuck can’t even get a website up and running no matter how much time and money he throws at it.