Stumbling through the dark, tortuous maze of Medicare, Medigap, and the Ripoff Prescription Plan paralelled Harry Potter's search for Lord Voldemort's  horcruxes.  I needed every one of my  librarian, social worker, and internet skills to come up with the best alternatives. Elders who are not internet experts seem doomed.  Insurance company representatives are not very helpful or well-informed. I highly recommend both the Medicare Federal site and the New York State site if you are fortunate enough to live in NYS.  I became eligible for Medicare July 1, the month I turned 65 on July 17.

My husband is 49; he will be employed for a very long time. (He has my permission and encouragement to remarry if I don't live to 110.) What my husband's employer pays for our Oxford's HMO is going up. Fortunately they cover the whole cost. Oxford Liberty  is not a particularly good plan. The copay for your primary provider is $30, for a specialist, $50. The primary doctor has to refer you to a specialist, usually adding $30 to the $50. His boss suggested that I investigate other options that they would pay for me.  His mother-in-law did much better than Oxford for less money.

 Medicare is secondary to Oxford because his company has fewer than 20 employers. I had to enroll in Medicare Part B  or Oxford would cancel my policy. Oxford HMO plays very badly with Medicare.  I would have to jump through all their very restrictuve hoops that Medicare doesn't require--doctors in network, referral to specialists. They would never pick up charges that would enable me to pay less than if I got the service through Oxford, e.g., they would require a $50 co-pay for mental health. The only decent part of their plan is their prescription drug coverage, and it doesn't mean much because all my drugs are generic. 

Medicare is not as comprehensive as people think it is. Medicare A is free for anyone who has accumulated 40 quarters of Social Security payments. Medicare Part B that pays for outpatient care is $110 monthly. Medicare only pays  80 percent for most services and imposes deductibles.Their coverage of mental health is much worse; until this year it only covered 50 percent.   Parity will only be reached in 2014, when they pay the usual 80 percent. In 2010 they cover 55 percent.

All insurers are required to provide the same benefits in for a specific plan, but it pays to shop around.  Rates for Medigap Plan F on Long Island vary from  AARP's $240.25 and Empire's $294.73 to State Farm's $422.13.   AARP is the cheapest, but I had to talk to three agents before I was assured that they would pay the mental health costs that would be out of pocket without Medigap. Yet all medigap policies are required to pick up what Medicare doesn't pay, and in 3 minutes I could easily find 500 sites that spell that out.. I offered to read the federal regulations, but they didn't seem interested.

Empire was far more responsive, and an agent called to schedule an at home visit the same day. She seemed very well informed over the phone. It would take four business days for AARP to put me in touch with a local representative who could schedule a visit.  I am afraid my experience with AARP United Health Care when I was trying to buy a policy would be repeated everytime I visit a doctor. 

 The United Health Care's AARP plan representatives told me they are never asked about mental health costs. I suspect that is because most people are under the illusion that parity has been reached. Alternatively, all their members are crazy enough to believe they are entirely sane.

Medicare Prescription Plans Part D seem to be a total ripoff. People would be better off buying their generics through Costco and not having a plan. But they are forcing everyone to sign up by imposing a penalty for the lifetime of your policy if you don't sign up  during the first six months of your eligibility.  The premiums range from 25 to 75 and usually there is a $350 deductible. I have found one plan that would cost be under 1000 in drug costs for my current drugs.  There is no deductible and the premium is $51. The copay for each of the four drugs I sometimes take is $7 each.   If I bought them at Costco, my total drug payment for the year would be less. I suspect I will always take generics, but given how the FDA approves new drugs, I will be better off.  At least you can change drug plans each year.

So his company says they are willing to pick up my costs for Part B,Plan F, and the Drug Plan, 50-75, whichever plan I take. I will almost certainly be better off. But I need to get in writing what they will pay me each month, and not try to pay me through my husband's salary. If they did that, we would be paying Social Security and state and federal income tax on the amount. You can only deduct medical costs that are over 7.5 percent of your gross income. It is illegal not to provide health insurance for a spouse over 65 if the employer provides it to spouses under 65.