WASHINGTON — The federal government has once again extended its annual invitation for Americans over 65 to correctly guess which insurance product will keep them alive the longest. Seniors have approximately two weeks left to select the healthcare coverage that will either sustain them or bankrupt them, depending on factors no one fully understands.
Available plans include names like UnitedHealth Pathway Premier Select, Humana Gold Plus Choice Secure, and Cigna HealthSpring Preferred Flex Value Advantage, all generated by a random word algorithm that achieved sentience in 2014 and has since refused to explain itself. Each plan covers a slightly different set of services using a slightly different formula that requires a slightly different spreadsheet to decode. Seniors are encouraged to compare all options, take notes, and then call an adult child for help.
Costs are rising, because costs are always rising. Part A’s deductible will climb to $1,736 next year, while Part B premiums will reach approximately $203 per month. Asked whether seniors should consider this an investment in their health or an installment plan on dying, a CMS spokesperson said both interpretations were valid and that either way, the form was due by the 7th.
For those who find Original Medicare insufficient (and statistically, everyone does), supplementary coverage is available. Medigap plans, Part D prescription programs, and Medicare Advantage products can be layered on top of each other like bureaucratic lasagna, each adding its own premiums, deductibles, copays, and fine print written by lawyers who retired years ago on excellent insurance.
“It’s actually very simple,” said Harold Grubb, a licensed Medicare counselor from suburban Phoenix who has been explaining these policies for 19 years and now speaks with the slow, distant cadence of a man who has seen things. “You just need to assess your current health, predict your future health, compare that to a matrix of available products, verify provider networks, check formularies, cross-reference costs, and then hope you guessed right. Most people do this in one evening. Other people cry for days. Can’t say as I blame them.”
Lower-income seniors may qualify for both Medicare and Medicaid, a scenario the government calls “dual eligibility” and enrollees call “the only way I can afford my pills.” Qualification requires submitting detailed income and asset information to a state agency, which will process the application at its own pace, defined legally as “between now and your next birthday, whichever comes first.”
Those who qualify automatically receive Extra Help, a program that subsidizes prescription drug costs and sounds like something a caseworker says right before the really bad news. Seniors are encouraged to contact their state health agency immediately if they believe they need assistance, and also if they don’t believe they need assistance but might, because in both cases the paperwork takes literally months and they’re all going to die soon.
In the meantime, Medicare offers several preventive services at no additional cost, including screenings for diabetes, cardiovascular disease, and cancer. If caught early, these all may be treatable. If caught late, they arrive with their own built-in deductibles. Officials say these screenings represent Medicare’s commitment to early intervention, though some participants note that being told what’s wrong before you can afford to fix it is a time-honored American tradition.
For prescription drugs specifically, advisors recommend searching for coupon codes online, a strategy that sounds made-up but apparently works. Several discount services allow users to compare pharmacy prices, enter codes at checkout, and receive medications at reduced cost. Essentially like Groupon, except instead of kayaking lessons for fun you’re negotiating for blood thinners that you need to not die.
“I saved $40 on my cholesterol medication,” said Marjorie Stendahl, 71, of Tulsa, who found a code on a website called GoodRx. “I don’t understand why this works, and I don’t understand why I have to do it, but I did it, and now I have enough left over for half a tank of gas. That’s American healthcare for you.”
The open enrollment period officially closes on December 7th. After that date, seniors will be locked into their selections for the year unless they qualify for a Special Enrollment Period, which requires a qualifying life event such as moving, losing coverage, or developing a condition so severe that the federal government feels briefly bad but still does nothing about it.
Officials say the system is working as designed. Participants have not yet responded, possibly because they are still on hold, or died trying.
