Wednesday, November 07, 2007

Fixing for a MedAdvantage/health care fix

Since turning 65 earlier this year I have entered the uncertain world of Medicare. Stories about Medicare, it seems, are part of the lore of aging.

My transition from my pre-senior Kaiser Permanente coverage to Regence Blue Cross MedAdvantage was seamless back in February, when I entered seniordom.

I signed up for the Regence program because it looked like a pretty good deal at $45 a month, plus the $93.50 I pay monthly for Medicare.

But about a month ago I realized that each year I would be buried under a blizzard of fliers from competing Medicare Advantage programs, which envelop and supplement Medicare’s spartan coverage. No doubt Regence has been out trying to woo other seniors away from their own coverage and over to the Blue Cross/Regence program.

Of course the advertising blitz comes at a price, born by us, the enrollees. The marketing campaigns have absolutely nothing to do with our health care. Trust me, they don’t do this in Sweden, Denmark, New Zealand and Canada.

Then, in the middle of this flurry of brochures and sales pitches, I received in the mail my “2008 Annual Notice of Change” from Regence. That’s innocuous sounding until you realize that the primary change was in what I would be paying.

Starting January 1, my monthly rate will go from $45 to $75.

I blinked, but my eyes did not deceive. That’s a 67 percent increase. Over the year, I will fork over an additional $360 to Regence. An extra dollar a day.

Did someone say “bait and switch”?

Suddenly I realized why I was getting all those fliers from the competition.

Fortunately, I can afford to pay more. But where will this stop? Will Regence gouge me another 60 or 70 percent next year?

And what about all those folks who can’t afford the increase?

“Fixed income.” means exactly what it says, “fixed.” I’ll bet the CEO of Regence isn’t on a fixed income.

The health care system clearly is in a fix and needs desperately needs one.

I decided to give Regence a call.

My ploy was to play stupid. “There must be some mistake,” I said to poor Amanda, a Regence customer services representative who answered the phone. (Good news — she didn't sound as though she was fielding my call in sunny Bangalore.)

“You have to understand we are a non-profit company," she explained. "We base our rates on what we paid for claims in the previous year. If we save this year, our premium will go down.”

“Will it go back down to $45?” I asked.

Amanda, wouldn’t commit.

“Has it ever gone down?”

Amanda didn’t know. She’d only been a customer rep for 18 months, but, she added, “A lot of people don’t understand how insurance works.”

“Well,” I said, “either Regence isn’t making itself very understandable or I’m beginning to understand all too well.”

She agreed that the rate increases were tough to budget for. I suggested that Regence customers be warned well in advance that big rate hikes like this one were possible, even inevitable.

She said she would pass my “excellent” suggestion on to her supervisor.

Finally, I asked her whether she had been getting many calls like mine.

Oooooh, yeah,” she said wearily.

Weep, Lyndon Johnson, who signed Medicare into law in 1965. Clearly the days of free or low-cost medical care for seniors are numbered, at least under the Bush administration and probably under any administration beholden to the insurance industry.

And, looking to 2008, which candidate is least likely to be so beholden? Here's a clue. Watch for others.

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