AltHealth: Senior Moment

My friend Laura turned 65 last week and she’s angry as hell. As well she might be – the US government threw her one helluva surprise party.

Laura has been a freelance artist her entire adult life. For most of that time, she was without health insurance, but in 2014, Obamacare bestowed the gift of free health care upon people like Laura who lived from hand to mouth and for whom health insurance was an impossible dream. It was an unexpected blessing for Laura, who suffered from a chronic autoimmune disorder and occupational injuries she’d never been able to properly address. Her eligibility for insurance was based solely on her income, which was sporadic and meager at best. She visited HealthSource and came away with a policy that had no monthly premiums and zero co-pays. For the first time in 25 years, she could get a much-needed set of diagnostics and attend physical therapy. It made a big difference. After a solid assessment by an orthopedic doctor and 2 months of PT, Laura felt significantly less pain and fatigue.

But when Laura turned 65, all that changed. One day she had Obamacare, the next, she had a bill from Medicare for $406 and a complete change in coverage. It was an unpleasant welcome to the wonderful world of senior citizenship. She could have Medicare Part A for free, but it only covered her if she ended up in the hospital. If she wanted any help at all for doctor visits, physical therapy, preventative screenings or other  health extras, she had to sign up for Part B, and apparently, getting off Part B once she signed up wasn’t as easy as saying no. She would still be charged a penalty every month. If she wanted the basic AARP Advantage Plan, it was going to cost her $136 a month. Her co-pay for any specialist was $45 and if she wanted to go to physical therapy, it would cost her $40 a visit. Laura did the math – a 2-month plan of therapy would cost her $640. It would take every cent she earned on her jobs. What was she supposed to live on? She applied for government assistance.

Laura was denied Medicaid despite her low income because she’d had the foresight over the years to put aside any money she could in savings. It was barely enough to see her though half a year of living expenses if anything happened to her, but the government thought that was too much. Their cut-off point for savings was $4,000.

“Four thousand dollars!!! Do they think that I still live at home with my parents???” I could hear Laura even while holding the phone a arm’s length away from my ear. She couldn’t wrap her head around it. “Who the f__k decided that it’s okay to have savings while you are still a viable member of the working community, but the second you retire and can’t save anymore, you aren’t allowed to have ANY????” She was livid. “What MORON came up with that one?”

Laura filed an appeal and came to the hearing armed with facts and figures. She was on food stamps. She didn’t have a job. Some months, all she took in for freelance was $150. If she filed for retirement at age 66, all she’d get was about $470 a month after Medicare was deducted. Her basic living expenses came to $700 a month. The jobs that brought her the most income were very hard on her body and she needed physical therapy once or twice a year in order to keep working. After paying for her insurance, how was she supposed to afford the co-pays for medical services she needed?

The DHS workers were sympathetic. They understood what she was saying. But the numbers were the numbers. She had too much in savings and there were NO exceptions made. “But at this rate, I’ll go through my savings in a year, two at best! What will I do then?” The smiling DHS workers had a solution – when she lost all her money, the government would be glad to reconsider her case.

So Laura keeps limping along as best she can, while her savings slowly diminish. She’s considering adding a fee to her freelance invoices to cover physical therapy, but she fears losing clients. No one in RI is rolling in the dough right now, and businesses don’t want additional fees any more than she does. She wishes that she could hang it up and quit, but she just can’t afford to.

For more information on Medicare, visit usa.gov/medicare

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