Fondation Van Gogh in Arles

Medicare insurance is highly confusing, and getting all that material in the mail to “help” you doesn’t help. Even if you can stay awake while reading it, comprehending it is another story.  Medicare is available to all people who have worked for more than 10 years and paid into the system. Part A which covers hospitalization, does not have a monthly premium once you are eligible. This was already paid through payroll taxes.

Medicare Part B does have a monthly premium and the amount is based on income and starts around $100 per month. This is either paid quarterly by check or deducted from one’s social security check each month. Most people prefer to have it deducted. Many people as “why isn’t my Part B free like Part A?” Medicare Part B actually pays 80 percent of your medical bills therefore it requires a monthly premium.

Upon turning 65 people have a six month period entitled the open enrollment period, which allows them to enroll in a Medicare supplement Plan with no medical underwriting. This is fantastic for people with health conditions who would normally be turned down for any insurance. During this time period you can enroll with no medical questions asked. Many people choose a Medicare Supplement Plan F, often called a Medicare Part F. With this plan you pay no coinsurance, no copays, and no deductibles. It offers 100 percent payment of the gaps in Medicare and is outstanding coverage for those wanting to supplement Medicare Part A and Part B.

People can also enroll in a Part D drug plan within 4 months of the month they turn 65. These plans have a monthly premium and some have deductibles. You then pay copays on your prescriptions, although some offer generic drugs for free. It is best to compare plans at Medicare.gov to see which plans will save you the most money, by entering your drugs into the plan finder tool.

Some people also choose to enroll in a Medicare Advantage plan rather than stay with original Medicare. These plans are either HMOs, Private Fee for Service options, or PPO’s. They have networks and are managed care plans in which you must visit a participating doctor. There are usually copays attached and a monthly premium to be enrolled in one of these.

Knowing the various parts of Medicare can be of great use for those eligible for the coverage, and it’s always best to shop as many companies as possible for Part D drug coverage as well as a Medigap or Medicare Advantage Plan Option.

After my last post I received a number of emails regarding my wife’s insurance and how we used it abroad when she hurt her ankle in France. I decided to put together a little article to help those coming up on Medicare age. Hopefully all the many hours of research I did can help others save time and money!

What is Medicare?

Medicare is health insurance provided by the federal government for people 65 and older. Many of my friends say it’s the best thing about turning 65. It’s also for people under 65 with certain disabilities and anybody with end stage renel disease. Medicare pays for healthcare costs such as the doctor, the hospital, and prescription drugs. However, it doesn’t pay for all healthcare costs. Medicare beneficiaries are responsible for co-payments and deductibles.

What are my Medicare coverage options?

Medicare beneficiaries can choose among the following.

Number one, original Medicare. This is Part A for the hospital and Part B for the doctor. Part A is free. Part B has a monthly premium that is deducted right out of your social security check. There are no network restrictions.

Number two, Medicare Advantage plans, also called Part C. Often, these have zero or low premiums. However, there are network restrictions, co-payments and deductibles. These are health plans run by private insurance companies that are approved by Medicare such as HMOs and PPOs. They provide insurance for hospital and medical services and sometimes, prescription drug coverage.

Three. Medicare prescription drug coverage, also called Part D. Medicare offers prescription drug coverage for everyone with Medicare, either with Original Medicare or Medicare Advantage. Medicare drug plans are run by insurance companies and other private companies approved by Medicare. Beneficiaries must enroll and pay a separate premium for these plans.

What are Medicare Supplement plans?

Medigap Plans, also called Medicare Supplement plans, are private health insurance specifically designed to supplement and work only with Original Medicare. Private insurance companies sell Medicare Supplement plans. So, while parts A and B of Original Medicare have co-payments and deductibles, the Medicare Supplement plans or Medigap policy is designed to pay for what Medicare does not pay for. There are no network restrictions. You can go anywhere in the United States as long as the hospital or the doctor accepts Medicare, they will accept your supplement plan. As well, several of the plans offer the emergency travel benefit that Sally and I used in France which is wonderful. We had a $250 deductible, then the plan paid 80% of emergency coverage. This is MUCH better than I thought it would be and I’m grateful we had it.

To summarize, when you’re on Original Medicare parts A and B, you will often choose to have a Medicare Supplement plan to take care of what Medicare does not take care of. You may also choose a prescription drug coverage plan to pay for your drugs, as it is not included in a Medigap policy.

I hope this helps everyone who wrote in, just be sure to shop around and check prices from all the companies. They all have the same coverage, but have different prices.

Upon my first visit to Arles I wasn’t quite sure what to expect. With Sally and I both retired and now laying down our “bucket list”, we realized something. It’s easy to MAKE a bucket list, it’s the execution part that is difficult. The Van Gogh tours in Arles were our, well my, number one choice and at the very top of my list for the last 5 years of revisions we’ve both been making. Rome, Australia, and Machu Pichu round out the list. That’s just the travel category.

Thankfully my wife allowed my first choice to take priority, considering I was the bread winner for the last several years. My love of art started when I was a young boy, and my father took me to the Met in New York City. When I first arrived, I was extremely upset once I realized there were no toys. In fact it wasn’t until many years later when I was in high school art class that I truly realized the gift my father had given me. God’s delays, truly are not God’s denials.

Van Gogh’s work struck a chord with me like no other. I’m no romantic (my wife might disagree never to this) and I don’t cry at Broadway shows (The theatre was just dusty at Les Mis’ in 1998). But I firmly believe that everyone’s soul is programmed to be touched in such a way of inspiration by the works, be it music, song, dance, or art, of other men or women. It’s God’s way of transforming his love on earth, and we feel this through emotion. Not terribly rational for the scientific mind, but then again there aren’t many great scientists creating great art either.

We arrived in France jet lagged but smiles on our face. Frequent flier miles helped, as we had upgraded to first class with my left over business miles. If you can ever make this trip via first class I assure you it is worth every cost. In this case it was worth every cost to my previous employer.

We quickly gathered our bags and caught a taxi to Arles, as our first walking tour was on schedule for that day. I still owe my wife a favor for booking us that solid. The smell in the air and the glass of wine we had to kick off our adventure were magical. As the tour began we learned of all the placards perfectly located where Van Gogh’s easel was set up to create his masterpieces. To stand in the exact same spot where “Starry Night” was brushed, or where “Evening Café” was painted was simply incredible. We took a stroll over Trinquetaille bridge where violins played and we glanced at a reproduction of “Staircase of the Tinquetaille Bridge” as well as along the Rone River Quay.

It wasn’t until we stepped off the bus at our hotel that things took a turn for the slightly worse. Sally blames it on the jet lag and vino, but stepping off the tour bus she twisted her ankle and immediately told me “It’s bad.” Not something you ever want to hear your wife say, even in your home country, about anything. Our concierge say what happened and was quick to his feet, directing us to the nearest medical center. My thoughts were focused on her injury just being a slight “twist”, as twist was the only word I could come up with in my limited medical vocabulary that sounded like it would heal in 24 hours. Not because we had our Van Gogh walking tour at 5pm the next evening, but more, because…we had our Van Gogh walking tour the next evening.

If this was the first stop on our bucket list, this was going to be a long ride. We brought Sally to the medical center and 25 minutes later my fears were put to rest. Just a twist and nothing ice and a few pain killers couldn’t handle. The Xrays and additional tests however quickly entered my mind after hearing the good news, as I had no idea what the bill could possibly come to. It turns out Sally’s Medigap Insurance paid for 80 percent of her medical bills.  Not too shabby for France.

We agreed on a bottle of wine to take back to our hotel room after this first crazy day in Arles, and we (More like I) agreed on an early wake up call to begin her rapid physical therapy as we had a lot more walking to do in Arles!

The next day thankfully it was as if nothing had happened (Viva le France!) and we were off and running after a wonderful breakfast at the café outside our hotel. We headed to a small courtyard called Espace Van Gogh and it was lovely. Recreated to look exactly like it did when Van Gogh painted “Le Jardin de la Maison de Sante a Aries”, it contains fantastic tributes from contemporary artists that truly compliments it’s beauty. With Roman ruins in the background, it was quite the setting for our perfect 2^nd day in Arles. Injury free!