Summing Up – Medicare

In this country you get Medicare when you turn 65 years old. It pays for a ton of stuff, but not all, and that’s where the vultures come in, namely HMOs that promise that for a certain amount of money, they’ll fill in the missing money that Medicare doesn’t pay.

Actually, these go-between Health Management Organizations are profit making, and they often make it more difficult to get your Medicare needs taken care of.

A small example: I was a member of an HMO called The Mt. Sinai HMO which made sense (to me) to join since all my doctors were at Mt. Sinai.

So then I had my two strokes, and while I was in the neurological wing at Mt. Sinai, a letter arrived, which nobody thought to open, which I found out later said that the Mt. Sinai HMO was being dissolved and none of my doctors were being covered.

But I still had Medicare, and all the doctors accepted Medicare, so I should still be covered but no. The hospital said they could no longer accept patients with Mt. Sinai coverage and I had to cancel that coverage asap.

So after getting out of rehab, I called what was the parent company of the HMO and asked to have the insurance cancelled.

Why do you want to cancel your insurance, sir?

They always think that if they call you sir, you won’t notice that they are screwing you.

Because you no longer cover any of my doctors at Mt. Sinai.

That is true, sir, but we suggest that you switch doctors.

Listen, I reply. It took a long time and a lot of research to get the doctors I have. I like them. Why would I switch doctors because you no longer cover them. As a matter of fact, most of the time you fouled things up by — oh, I don’t want to get into it. Just cancel the insurance.

Yes sir. I’m sorry you feel that way. Do you have a fax machine?

No, I don’t have a fax machine. I didn’t have a fax machine even 20 years ago when they were popular. Can’t we do this by e-mail?

No sir. We will mail you a letter with a form to fill out. It should take from 5 – 10 days to reach you.

Me: You realize that all that time I can no longer see any of my doctors.

Her: (It’s always some young girl named Carol-Ann sitting in an office in Iowa or somewhere in the midwest. Believe me. I once asked the Humira Ambassador where she was located and what she saw out the window and she said she saw fields of wheat, as far as the eye could see, and these Humira jobs were all they had in the town); To continue: Carol-Ann says it is a legal requirement to fill out this form.

I check to make sure she has the right address, and I ask if she can email me when the form has been sent.

She tells me she’s sorry but the mail comes from a building in Florida, and she would have no idea.

Okay, I say.

And then the famous fix-it phrase which I may have to shoot myself if I hear it again (I think I heard it yesterday with the collection service) Is there anything else I can help you with?

I’m not going into George Carlin material here, but I am tempted.

Eventually the letter arrived. I filled it out, although the stroke had effected my writing hand, but somehow got it done, then had my visiting nurses aide, take it to the store on the corner and fax it and get a receipt.

END OF PART 1 (getting old in America)