Thursday, April 28, 2016

Health, Insurance, and Vera

What better way to start of this blog than to be recovering from a PTSD-related anxiety and panic episode?  Thank goodness I have health insurance. Right?

Well, remember folks, it all depends on what kind of health insurance you have, based on how much (if any) you can afford.

Which leads to my upcoming transition from Medicaid to Medicare.


Exactly, Dear Reader.

But you ain't 67 (years old) yet. How you going to get Medicare 32 years before you're supposed to?

Easy. Because I'm special.

Uh-huh, Vera. And I suppose the Cleveland Browns are going to pick a legit player in this year's National Football League (NFL) Draft, right?

Well, since Hell hasn't frozen over just yet, let's stick to how this brat can get into Medicare.

Okay. Shoot.

I'll do a timeline of sorts to explain how I got to this point.  Ready?


In December 2013, I left my job; everybody (who has been following this blog) knows that.  The first two things I had to establish for myself after I left my job (because I knew I was sick as hell) were bankruptcy and disability.  Bankruptcy is a legal procedure in court where someone tells a judge that they are no longer able to pay such extraordinary amounts of bills (hospital invoices, credit card charges, car loans, house mortgages, etc.) in hopes that the judge would either grant them partial or total relief from their financial obligations.  Disability, in this scenario, is shorthand for "Social Security Disability Insurance," or SSDI.

There are two ways (that I am aware of) to receive Social Security benefits here in the United States; through retirement and through disability.  The earliest age one can retire to receive benefits is at age 62; the catch is that the person will only receive a percentage of their benefits because they started early. Unless you were born before January 1, 1960, the retirement age (in order to receive full, not partial, benefits) is at 67.  To receive disability benefits, on the other hand, someone (or an advocate on their behalf) have to show proof of disability to the Social Security Administration.  There is no age requirement to receive SSDI or Social Supplemental Income (or SSI); both SSDI and SSI are based on how much someone paid Social Security taxes from their employment and how much in assets does someone have assigned to them.

Fast forward several months into July 2014, I was granted a discharge (approval) of my bankruptcy filing in court and was given my first SSDI payment.  How Social Security operates is they will determine the day someone became disabled, add six months, and then round up to the first of that sixth month, to award them with their first payment.  Except you have to wait a month because Social Security runs a month behind. Joy.

Follow me, if you will.

Vera left their job in December 2013. Vera then filed for disability (SSDI) in January 2014. Vera (the lucky sumbitch that they are) was awarded (granted) to receive payments from SSDI in April 2014 by postal mail.  Social Security determined that Vera became disabled (and therefore awarded to receive cash money) on the day they left their job back in December 2013.  Add six months to that, it's June 2014.  Round up to the first of that month, Vera's SSDI became effective on June 1, 2014.  Vera's first payment was processed and then delivered to Vera in July 2014 (again, because Social Security operates a month behind schedule).

Now, this is where it gets interesting.

After all that mess, I also qualified for Ohio MAGI (Modified Adjusted Gross Income) Medicaid, because my brand new income was within the poverty guidelines set by the state (and I was then, and still is now, a single childless adult).  In order to receive Medicare (which the federal government health insurance program), I have to be on Ohio MAGI Medicaid for two years (as of this post, I still have Ohio MAGI Medicaid).  Since I started earning SSDI benefits on June 1, 2014, my Medicaid would end and my Medicare would begin on June 1, 2016. Yay me.

In February of this year, just a couple of months ago, I started receiving booklets and documentation from Social Security about "Welcome to Medicare!" Basically, all I got was a crisp and freshly printed Medicare card for me to use, as well as a bunch of letters, stating that I need to pick Medicare plans that would best suit me between the mailing date and May 31, otherwise I would have just Original Medicare starting on June 1.  Um, okay; that doesn't read like it's that difficult, right?


A few weeks ago, I decided to inflict unnecessary injury to my brain by looking up all these words and shit about what Medicare is, what Medicare does, what do I qualify for, and so on. Part A, Part B, Part D, skip, reverse, draw four. It's bullshit. If my sorry 35-year old azz couldn't understand what the fuck I was looking for, just how in the hell should I expect a 62-year old or a 67-year old to understand this epic maze of jabroni?

Hell, even I don't understand that shit.  And I'm not disabled or retired yet.

Lucky you.  I've decided to tackle this Medicare nonsense head on, because it's better to be safer than sicker.

Medicare's Part A: hospital coverage. It's to make sure that azz is taken care of while you're laid up in the bed at the hospital.  Anywhere from emergency room visits to operational procedures, Medicare's Part A will cover your hospital stay.

Medicare's Part B: medical coverage. Yes, in the USA do we have coverages separate from hospital and medical.  Medicare's Part B takes care of maintenance stuff, like doctor's visits, annual physical exams, and inoculations (including the yearly influenza vaccination).

Let's stop here for a moment.  In order to receive Medicare Parts A and B, you have to pay a portion of your Social Security check each month to Medicare.  Some folks qualify for additional financial support through Medicaid, but each state is different; check with your state Medicaid office for more information. Hell, some folks on Social Security elect not to be on Medicare at all; all of these parts are electable, meaning you can pick out whatever health coverage you want.  Once that decision has been finalized, however, you will have to stick with that health coverage until a span of time (called "open enrollment") becomes available for you to make changes.

Medicare's Part D: drug prescription coverage. Believe you me, this already annoys my undiagnosed obsessive-compulsive disorder, but there is a reason why D is before C.  In the USA, large pharmaceutical corporations (see: Big Pharma) practically have a stranglehold on most hospitals and doctors alike, charging whatever ung-dly amount they see fit to make a profit and keep their shareholders happy. So already, to purchase prescriptions without drug coverage is nothing short than financially astronomical.  What Medicare's Part D does is it will alleviate some the cost of your prescriptions.

Medicare's Part C: an exotic blend of herbs and spices. No? Okay. Medicare's Part C is better known as Medicare Advantage, where private insurance companies work with Medicare to provide more services at an additional cost.  For example, Original Medicare (Parts A and B only; Part D is not in Original Medicare) does not cover visits to the dentist or the eye doctor. A plan in Medicare's Part C (believe me, there are HUNDREDS of plans to choose from, ugh) does.

This is the part that is more puzzling than Autism Speaks.

Part C can be basically a combination of Parts A, B, and D. You can have just Parts A and/or B only. You can have Parts A or B and D without a Part C plan. You can have Parts A and/or B covered by a Part C plan, and elect to have a separate Part D plan. The only thing you can not have is an A, B, C, and D plan.  Ain't that some shit?!

Now that I got the both of us dazed and confused, Dear Reader, allow me to finish up by how I ended up selecting the Medicare combination for me.

Ow. Please do.

In the State of Ohio, there is a Department of Insurance, I kid you not. This hotline of folks help Ohio residents find the best insurance coverage for whatever they need; medical, auto, homeowners, etc.  So I'm on the phone with this guy (who I find out their birthday is two days after mine, heh), trying to help me pick out the right Medicare thingy.  After navigating through which doctors the insurance companies work with and all that proverbial red tape, I finally selected a Part C plan that has both Parts A and B and a Part D plan, all rolled into one.

There are only two things I have to bitch about: 1) my copay (or my payment for services) for my mental health team is $50 for each doctor, ouch. And 2), all of this Medicare fluff I got myself involved with is only good until December 31.


Better you than me, Vera. *chuckles*

Oh, hush you. You wait until it's your turn to be on Social Security.

If there will be a Social Security when I retire.


  1. Wow, I simply had no idea how intricate it was to get benefits here in the United States. I guess I simply took it for granted that I would worry about it when I needed it. I will say that I am glad to hear you were able to get the coverage you needed though. Hope to read more soon.

    Joshua Duncan @ Focus Insurance Atlanta

  2. Great Post and it is really informative and helpful. Keep updating more topics on Health Insurance

  3. Thank you for trying to explain this Medicare mess to us. I am in the process right now of buying my own health insurance plan, as I am no longer covered by my employer, and it is definitely one hot mess. You have to wonder why America makes it so difficult for its citizens to get the basic care they need.

    Jason Hayes @ DECORM

  4. Nice and interesting information and informative too. Can you pls let me know the good attraction places we can visit: health insurance policies

  5. Yup, been there, living that "adventure" since 2006 myself. To be honest, as much a hassle as it has been, and continues to be, Medicare finally gave me answers to some bizarre genetic medical problems that had never been diagnosed before and were life threatening. Medicare covered the 20,000 dollars in genetic tests. My copays for doctors are 10 dollars, for specialist, like my Endo and Autism doctor are higher, and through mail order pharmacy almost all my generics are free. It's some of the best insurance I've ever had and when I was working, I had some pretty good insurance, but it was still much more expensive and hard to handle than Medicare.

  6. Thanks for your post. I’ve been thinking about writing a very comparable post over the last couple of weeks, I’ll probably keep it short and sweet and link to this instead if thats cool. Thanks. Texas low cost insurance

  7. After reading all of that I am thoroughly confused. I need to research more before it’s my turn. I can absolutely see how trying to navigate through the system can be a nightmare. I commend you for figuring it all out but what a pain in the neck that you get to go through this every single year now.

    Randy Lawrence @ Goldin Legal

  8. You are correct because I am living proof you can collect when you are 40 years old. I was seriously injured in a car accident and when I applied, I was approved the first time. The money is definitely not life-changing, but it absolutely helps at a time when you think everything around you is falling apart at the seams.

    Robert @ Weik Bankruptcy Attorney