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Remember to watch the MOoP


Just when you think you’ve timed things pretty well … Just when you think you’re going to ease into your semi-retirement at least one step ahead of easing into your dotage … Just when you’re in the homestretch of 65 and think you can soon flop down in a hammock and listen to the breeze blowing through the trees, Uncle Sam slaps you in the face and demands a bunch of decisions that are far more difficult than any calculus test you ever took way back when your mind was more limber, and far more consequential. Uncle Sam wants some answers about Social Security and Medicare, and he wants them now.

Social Security is a relative walk in the park: The sooner you take it, the less you get. Just make sure to use a sharp pencil.

Medicare, on the other hand, turns out to be a nightmare about Part A and Part B and in some cases Part C and hopefully also Part D, with Part A covering inpatient hospital stays, care in a skilled nursing facility, hospice care and some home health care; Part B covering certain doctors’ services, outpatient care, medical supplies and preventive services; and Part C involving Medicare Advantage Plans. A Medicare Advantage Plan is a type of health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits, and may be a Health Maintenance Organization (HMO), a Preferred Provider Organization (PPO), a Private Fee-for-Service Plan, a Special Needs Plan or a Medicare Medical Savings Account Plan. Got that?

And then you have to face an almost unlimited array of supplemental plans (these are private plans, and you may need one to fill the gaps that Medicare doesn’t cover, so their literature starts appearing in your mailbox about six months before your 65th birthday). To give you an idea, here’s the list of private prescription drug (Part D) supplemental plans I got by simply going to www.medicare.gov and typing in my Zip Code: WellCare Extra, WellCare Classic, First Health Part D Value Plus, AARP MedicareRx Saver Plus, AARP MedicareRx Preferred, AARP MedicareRx Enhanced, Aetna CVS/pharmacy Prescription Drug Plan, Aetna Medicare Rx Premium, Blue Medicare Rx Value Plus, Blue Medicare Rx Premium, First Health Part D Premier, First Health Part D Premier Plus, Humana Enhanced, Humana Complete, Humana Walmart Preferred Rx Plan, Reader’s Digest Value Rx, United American-Enhanced, United American-Select, Cigna Medicare Rx Plan One, Cigna Medicare Rx Plan Two, EnvisionRx Plus Silver, EnvisionRx Plus Gold, Express Scripts Medicare-Value, Health Spring Prescription Drug Plan-Reg 2, MedicareRx Rewards Standard. All you have to do is investigate the costs and benefits of each and figure out which one is right for you. Good luck.

For someone like Yrs Trly, who can’t even manage to do his own taxes, this is “If you answered yes, go to page 16, line 7; if you answered no, go to page 7, line 16” – squared. Or maybe cubed.

And the deeper you delve into Medicare, the more fascinating terms and delightful acronyms you learn. Here are just a few: EHR Incentive Program, eRx Incentive Program, Medicare Assignment, Physician Quality Reporting System (PQRS). Also: ADL (Activities of Daily Living), ABN (Advance Benefit Notice), CMN (Certificate of Medical Necessity), CORF (Comprehensive Outpatient Rehabilitation Facility), DENC (Detailed Explanation of Non-Coverage) and that old standby COBRA (Consolidated Omnibus Budget Reconciliation Act). Also: ALJ, ACEP, ANOC, CHDR, DME, DME MAC, DMERC, DMEPOS, ESRD, EOMB, FEHBP, FPL, FQHC, HCFA and HIPAA. Also: the whole rest of the alphabet, which of course includes my personal favorite, MOoP (Maximum Out-of-Pocket Cost). Good luck.

Reach Glenn Richter at grichter@record-journal.com.



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