Medigap

I’ve always had an ambivalent attitude towards AARP. I always thought joining would be a bit like becoming a teamster: I would pay my dues, knowing I was contributing to activities that improved my life, even though I suspected I didn’t approve of everything the organization did. Now that the radical conservatives are considering targeting it as a way to destroy health reform, I might actually be willing to make a contribution beyond my dues.

The market for supplemental medicare policies grew from the fact that while the government sets the price for services, it tends to only pay 80% of that price. The rest is left to the patient.

My father had some kind of policy when he died from lung cancer in the 1980's that seemed to have covered everything. However, by the time Congress was considering the medicare drug proposal, anarchy (or genuine market competition) had taken over the supplemental medicare insurance industry.

Congress defined several levels of coverage, and that’s all any company can offer. The competition, if any, lies in prices and reliability of services. Most cover the medicare deductibles, but only plans F and J cover the 20% gap. The only difference between the two, is one offers $120 for "preventive care not covered by medicare"and $1,600 for "at home recovery."

Getting a definition of "preventive care not covered" is impossible. One reason I have bone density problems is my body doesn’t absorb vitamin D. Each year, as part of my physical, my doctor orders blood work to check my vitamin D levels. I can’t find out if that test would be covered by medicare or, if not, if it costs more than $120 and would be covered by plan J. I do know this year my insurance company set the amount that could be reimbursed at $75 of the $315 the lab billed.

Once I had some idea which medigap policy I needed, I found getting information on what was available where I lived nearly impossible. Every website tells you to check your state’s insurance regulator’s website to find what’s available. It took the better part of two days to find that site, and then all it provided was a list with 800 numbers that did not include AARP’s provider, UnitedHealthcare.

Of the 31 companies the state listed, 30 offered plan F and two offered plan J. So much for finding competitors with AARP.

If I go with UnitedHealthcare, it’s because I know the AARP card will be recognized anywhere (except possibly the state of South Carolina) and that it has a large enough pool that it can offer lower rates, if it’s so inclined. More important, even if AARP has put itself into the unfortunate position of both consumer advocate and company shill, it’s continued success depends on satisfying the former group of notoriously cranky people and that may exert some pressure on the quality of service and price.