Confused about Health Insurance?

In addition to Medicare I have a very generous employer’s retiree healthcare insurance policy which covers virtually any condition or procedure I can imagine needing. Of course, to enjoy this generous plan I also pay a generous premium, so, this being only time of year you can change health plans, as several recent mailings from insurers who want my business tell me, I thought I would look into saving myself some money and began to shop around. Now I wish I hadn’t even bothered. I had assumed I could understand the difference between health insurance policies but I now realize that there are people who make a good salary making sure that 99.99 percent of the American public, including myself, can’t understand them And I’m not even talking about Medicare, that I can understand. I am talking about the good old American way of doing business, the private marketplace.

First, I discovered that Medicare Advantage plans do not cover the costs that Medicare doesn’t. In fact, it seems some of them are more restrictive, so why they are called “Advantage” is officially beyond me. What I wanted was a Medicare Supplement plan, and what I found out is that only certain plans are available for certain zip codes. This used to be known in criminal circles as “carving up the turf.” If I enter the zip code where I live, I get to choose from seven plans, but if I enter the zip code of the place I do business, I could choose from 14 plans. It is immediately obvious to me that I am better off than the people who get to choose from 14 plans because I only have to be half as confused.

In the handy-dandy Medicare.gov “plan finder,” I am asked if I want drug coverage, and if so, what drugs am I taking. I list them, and Medicare.com tells me that they would cost me about $8,000 a year if I bought them on my own, without insurance coverage. This is interesting, because when I check with a pharmacy they tell me that it will cost me about 700 bucks a year. Even more interesting is that the lowest cost drug plan I can find will cost me 1100 bucks a year, including premiums, co-pays, co-insurance, co-this’n’that, and co-baloney.

When I look for a Medicare Supplement plan I have only to compare, side-by-side, seven plans in addition to my own, to see which covers what, and when. This is too mystifying. If I use one of my tried and true decision-making techniques based on the principle that “quality costs less” even if the initial cost is more, I will choose the most expensive plan I can find. OK, that’s the plan I am now on. But if I want to settle for second best I could save around 2,000 bucks a year, maybe. It all depends on the fine print.

Remember the advice to always read the fine print? Take my word for it, the way these things are written they can confuse you just as easily—and legally—with print the size of the first line on the eye chart.

At this point I am beginning to wonder if it is not worth paying the extra $2,000 a year to not be confused. I mean, that’s got to be a health care benefit, too, doesn’t it? And at this point in my confusion, it’s well worth the money.

I know there is a State Health Insurance Assistance Program that I can call for help, and I will, but I’m still skeptical—and confused.

Jim Elliott served 16 years in the Montana Legislature as a state representative and state senator. He lives on his ranch in Trout Creek.