Sharon Edwards

Comments:

• When my husband reached retirement I began the process of finding Medicare coverage for him. Having worked on the IT side of healthcare, I was the partner most qualified to do the search. I wound up in tears more than once. I resorted to paying a consulting firm to help me sort it out. Best $500. I ever spent. They clarified the issues most important to his coverage - my husband takes a very expensive auto-immune drug and has the potential for complications - and explained coverage pitfalls we should avoid in the future. The complexities of choosing healthcare coverage are really just insane. Not only are the "rules" and options overwhelmingly and unreasonably difficult and complex, they are different by state AND by county. Read carefully and note all of the many comments here, suggestions for resources and information and input. Then start looking into what hasn't been discussed - donut hole anyone? I reached Medicare eligibility last year and searched every option available to me. Based on 2 years of part-time employment at a local community college I am eligible for Public Employee Retirement Association (PERA) coverage in Colorado. And so is my husband!!! It is a Medicare Advantage plan without any of the restrictions I would have encountered with other Advantage plans. Their formulary covers my husband's medications and we have no restrictions on which providers or facilities we choose. Our costs have been reduced from over $25,000. per year to around $10,000. I can tell you about one catch to the plan - it is not listed as an option on the Medicare.gov site. If I had not been aware that my "part time job to keep me busy when the kids were young" offered this benefit, we would not have been so fortunate. A friend who works for PERA suggests that after retirement a couple of years driving a school bus or working the lunch room is more valuable than most people are aware.

  Post: The Medicare Maze

  Link to comment from May 4, 2023

• Our family is partial to postcards. Much cheaper than a greeting card to purchase and send. One line is acceptable, comments about the weather are appropriate, silliness is appreciated. Collecting freebies whenever possible is the way to go. I am currently sending a postcard every 3-4 days to a friend receiving extensive cancer treatment. The postcard doesn't require a lot of effort or concentration to read and I feel like I am staying in touch without overwhelming her will any obligation to stay on the phone or respond when she has nothing but her medical info to share. We have been teaching the younger generation how to write them. Kinda like a text - quick and easy, here's where to put the address. Put the address in your contacts on your phone! During a recent trip we took breaks to write postcards, which of course meant we needed to grab a cup of coffee or tea and sit down and enjoy sharing our "witty" comment.

  Post: Spreading the Word

  Link to comment from December 23, 2022

• The variety of options available, varies by state, medigap vs advantage, D or not, providers dropping into and out of states. It is next to impossible to make a semi intelligent decision, much less plan ahead. When my husband went on Medicare 3 years ago we finally paid a firm to investigate/explain our options as my husband has a condition requiring a very expensive medication. (Which with mfg. subsidy cost $5 per month before Medicare. But the subsidy was claimed by Medicare and with Part D we entered and exited the donut hole by February. If we had gone with an advantage plan we would have had a cap on drug costs that would have severely impacted our finances. ) I turned 65 this past July and was able to acquire coverage for us both thru the state public employees retirement association. The monthly cost is a fraction of what we paid for him, there is no out of network, his drugs are very reasonable. It is an advantage plan. It seems to be working well for us, however, being a very specific government plan it is not on the Medicare site to compare and the local SHIP volunteer had no info to guide with. We are now in the annual re-enrollment, so I am once again concerned about whether we have made the correct decisions. The columns re Medicare coverage have been thought provoking yet fail to cover the fact that everyone's situation requires a different solution and the resources are slim. Frankly, the whole system is criminally complicated and confusing. It is a burden we inflict on our aging population in the name of providing care. To be subjected to going thru this process annually adds a level of stress that is cruel.

  Post: Mind the Gap

  Link to comment from November 15, 2021