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Mabel Mobry, still spry after surviving for exactly a century, pined for the days when she could get high with reckless abandon before all those Draconian blue laws gummed things up. When she was younger, she’d gone to Woodstock and heard Jimmy Hendrix play the national anthem. She relished her infamous pot parties, toking up and going straight to the bong, and getting a buzz. She’d married a man named Buzz, her third husband, as a way to immortalize those halcyon days, but he’d died in the bicentennial year, 1976, and that was a while ago. But now, in 2009, the pendulum was swinging back. Downtown and in the suburbs, marijuana was alive again, quasi-legal, if you used it for medical purposes. Stores sold it openly, if you had a prescription from a doctor. But Mabel was quite healthy for a centenarian. “I don’t feel a day over 94,” Mabel said to her cat, Woodstock, a white Angora that liked to party. What could she do to get her bong out again, a relatively law abiding old lady’s simple pleasure?  

Suddenly she had a brilliant idea, concerning her 2010 Medicare Advantage plan, the documents comprising it just sitting on the blue kitchen table getting dusty. Rock music started pounding in her head, Led Zeppelin playing some sort of anthem. She felt the freedom to act like Buzz’s warm caressing fingers remembered. He was her favorite husband when it came to physicality. Ring, once was all it took as her trusted California Health Insurance agent, a devout liberal thank God, picked up.

“Mrs. Mobry,” he said, sounding like a cherub although he had to be at least sixty, “What can I do you for?” A free spirit, the guy liked the freedom to juxtapose. He was humming the Star Spangled Banner, our national anthem. 

She came straight to the point. Woodstock was listening and nodded his approval. “Can my 2010 Medicare Advantage PPO plan incorporate a prescription for medical marijuana? Would such treatments be covered?”

“Do you have any medical conditions that might apply?” asked the cherubic California Health Insurance agent.

Mabel thought about it, but didn’t want to lie. “I might be going blue blind,” she said, shading the truth just a mite, as she could still see well enough to watch the Freedom Bowl parade on television, with its colorful anthem playing.

“That might do,” said the cherubic agent, “That just might do you.”

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Our National Anthem

Maisie M. Mynah was a sweet blue haired sixty-eight-year-old from Eureka who other than being able to whistle the national anthem tended to repeat herself and mimic behaviors so that it annoyed those around her. She’d been married eleven times and was still searching for that special guy special guy special guy. After hearing so much lately about health care reform, she decided to call a California Health Insurance agent for advice about her 2010 Medicare Advantage plan. After bussing south from Eureka to the Los Angeles area in order to pay a surprise visit to Max, her 7^th estranged husband, the only one who could still stand her, she looked up an agent named Matt Lockard, whose office was conveniently located in Ventura near where Max kept his bungalow.

“Hello. I’m Maisie Mynah, we’ve never met, but I’d like to discuss switching to a Medicare Advantage PPO. Can I make an appointment?”

“Sure,” Matt said, “When are you coming down?”

Maisie told him her circumstances, repeating herself a little too often, Matt mused. As he listened intently, he waited for her monotonous and repetitive voice to trail off, only it never did, instead it seemed like she hummed what sounded ominously like “saved by zero” the cryptic refrain from a  Toyota commercial, over and over, in the manner of an anthem.  

When Maisie showed up face-to-beak, as it were, it got worse. She strolled into Matt’s office. The bluish-blonde-haired eleven-time divorcee’s gait seemed mincing. Her voice grated on the California Health Insurance agent’s ears. Even simple phrases like “I’d prefer a PPO” repeated like another anthem reminded Matt of toenails scraping across a blackboard.  “I have Medicare Advantage,” Maisie finally managed, “but a PPO will give me more freedom freedom freedom,” she blurted in a parroted paroxysm of repetitiveness.

Matt felt like he wanted to scream. Although he had the freedom to do so he was always so polite to his customers. It was like a curse in these situations. “I’ll set you up with a PPO Medicare Advantage Plan,” he said.

“You mean in my Medicare Advantage?” Maisie squawked. She then proceeded to repeat herself several more times, once again in the manner of an anthem.

Matt kept that cursed smile on his own face – right up until Maisie finally left.  For weeks afterwards, that Toyota  jingle “saved by zero” played inside his head like a trapped cricket.

Nelson J. McElroy’s golden hostas had been holding him hostage all summer long. It seemed like there were armies of hostas in their environs, a redundant beauty on the march. After tolerating the pervasive blooms from his recently purchased lawn chair for as long as he could stand it, while sipping on a glass of lemonade, he decided to get to work trimming the stems. His wife Gertrude ambled over. She watched as Nelson squatted on aged bent knees with pruning shears in hand. He mentioned he was feeling a little dizzy along with a twinge of nausea. “I should probably sit down,” he added. As he returned to his chair, Gertrude noticed his left leg having difficulty matching the stride of his right, the left step diminishing like a chimera with every stride.

Nelson collapsed, landing on his pruning shears which were fortunately positioned blades down. “Oh Nelson!” Gertrude heard herself exclaim. Fearing the possibility of  a stroke, Gertrude recalled Matt Lockard, a pleasant semi-bearded California Health Insurance agent, the one who’d sold them their excellent Medicare Advantage plan just last year. She herself had utilized their coverage with a hospital stay as recently as May when her gall bladder had acted up. She decided immediately to ring Matt up. Thank the insurance God he was there. “Yes,” he said. He always sounded so calm when she spoke to him. A moment later, the decisive Lockard had contacted the 911 operator and ordered an ambulance for the McElroys.

She watched him the entire way to the hospital, terrified but trying to be brave while sitting next to him as he reclined with the tubes already in him on the ambulance stretcher. Every bumpy jolt made her heart race.

Days later in recovery Matt Lockard came to see them both.  “How are you doing?” he asked, the question directed at her as well as toward her now responsive husband.

“I had a stroke,” Nelson said, “because of those damned hostas.”

“Stop your cursing!” admonished Gertrude as Matt Lockard barely suppressed a grin. 

74-year-old Padraig O’Brien loved to watch those scooter commercials on TV. “You can have your scooter, with no out-of-pocket expense,” the announcer crooned. Like several of his friends at the Elysium Trailer Park in Oxnard, Padraig was otherwise confined to a wheelchair. One day Padraig and several peers purchased dandy electric-powered scooters using their Medicare Supplement insurance policies to help defray their cost.  Visiting the Grand Canyon while maneuvering among crowds of tourists on their scooters didn’t appeal to anyone at Elysium, but once everyone had their scooters, something else became evident:  the thrill of scooter speed.

“I think we should set up a race track,” suggested Tony Pilano, at 79, a near-octogenarian assumed to be Elysium’s resident sage. Mary Falafel, who spoke Arabic but wasn’t a 73-year-old terrorist, preferring to decorate or draw, agreed. “I can make banners,” she said. She loved to draw nude men.

The race track was set up along the trailer park’s wide walking paths. In preparation for the big scooter race, the “main drag” was clearly marked by Mary’s banners, a few of them rather lewd. Fourteen scooters set to race lined up. Someone had brought a starter’s pistol. The electric hum of racing scooters was vaguely reassuring to many in the crowd of geezer gawkers. 

Tony and Padraig jousted for the lead, each rubbing the other like NASCAR drivers. Mary was running a strong third. As her scooter tipped, she reached for what she thought was a convenient handle …

 Exactly what occurred in those next crucial two seconds will never be precisely known.  

The aftermath featured the friendly California Health Insurance agent dutifully tying up loose ends after the participants had returned to Elysium. Mary brought up what was on everybody’s mind. “Let’s have another race,” she exclaimed.  A silence ensued leaving her words hanging in the California air.

A tear formed in Padraig’s eye.  “Tony would have liked that,” he concluded.

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Centenarian David R. Morse’s family should have seen the birthday cake disaster coming. When Great-great-grandfather Morse tried blowing out all the candles on his birthday cake, the result was predictable. If it wasn’t for a California Health Insurance agent, it could have been financially tragic for his family as well.

He lived with his extended family instead of in a rest home. It was a big family living in a big house. Grandpa-pa-pa as he was known to all was loved and revered. Although he hated celebrating his own birthday once he’d attained his late nineties, his annual party had become a family tradition, and Grandpa-pa-pa Morse reluctantly went along. The worst part was blowing out his candles with a single exhaled breath, a perfectly timed gust expelled from his increasingly frail frame that could put out all the candles at once so that he might “get his wish.” Last year at age 102 he’d wished for an end to this ordeal, but secretly of course, so as not to disappoint his younger kin. This year, the massive cake, with papaya-flavored frosting, was decorated with 103 candles, each like a tiny universe flickering. “Blow Grandpa-pa-pa,” shrieked eight-year-old Adam, already a little windbag who’d easily blown out his own candles, all eight of them, just two weeks before. The family’s beloved centenarian was gathering his remaining breath in a mighty storm at that very moment, but the task before him seemed immense. Could he still do it? Grand-pa-pa Morse huffed …. And blew with all the might he had. The result was strange. Instead of going out, the 103 candles suddenly blazed as one! Everyone in the room, a gaggle of Morses, gasped. Grandpa-pa-pa not only gasped, but began wheezing. “That’s never happened before!” exclaimed Mossy Morse, his family-values smitten granddaughter, age fifty-six, who already had grandchildren of her own, of which Adam was one. By the time Mossy’s husband Alexander realized there was an emergency, he’d begun putting the cake out with a nearby extinguisher. Adam screamed, “Grandpa-pa-pa!” when the boy saw their patriarch keel over. Moments later, they were all in the emergency room of a nearby facility, as Grandpa-pa-pa Morse was receiving urgent care.

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Mossy Morse said out loud what most of the clan had been thinking. “Thank goodness we anticipated this when we purchased a policy for our beloved grandpa-pa-pa from that friendly California Health Insurance agent we met on the pier at Santa Monica,” she said.

“Will Grandpa-pa-pa be able to blow out his candles next year?” asked Adam with a touch of naiveté. All Adam got for asking the question was a big hug from everybody – including his now reinvigorated grandpa-pa-pa.

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Sixty-seven-year-old Evelyn Saguaro had the same problem her late mother had once been afflicted with. Besides her real gall bladder, she’d been born with a vestigial secondary one in which three cactus-like gallstones, each about the size of a quarter, had formed. Late in life, the vestigial gall bladder’s gallstones were starting to act up. Sharp pains would erupt beneath her breastbone immediately after she ate even a tiny serving of anything, and the acute pain made her sick to her stomach. When her doctor ordered tests to identify where the symptoms were originating from, he told Evelyn that her Medicare Plan only covered her original gall bladder, and since the stones had formed in the vestigial one, any procedure to remove them in “her unique case” would not be reimbursed. Her primary care physician kidded with her. “I suggest you refrain from eating,” he said. “Are you serious?” she asked. “No, a better idea might be to seek out a California Health Insurance agent.”

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That’s when she realized that she had done just that, two years previously. Was her Medigaps supplemental still in force? She headed on a beeline to the Visalia office where she’d purchased the Medigap coverage. Was the office still there? It was. The same agent, Glenda, was at her familiar desk. During their previous conversation which she’d somehow forgotten, Glenda had shared with her that she too had a “vestigial gall bladder,” with its associated symptomology not yet evident. Glenda had even belonged to an online organization, a regular support group called VGB Sufferers International.”

“Glenda, I’m so glad to see you,” Evelyn began. “Is my Medigaps policy still in effect?”

“Why wouldn’t it be, dear? Let me check.”

Evelyn waited expectantly. Suddenly her gallstone pain returned with a vengeance. “Is it? She asked, almost gasping.

“Of course it is, my dear Mrs. Saguaro.” A month later, Evelyn’s surgery was successful and her cacti-shaped stones were displayed on her mantle, and on the VGB Sufferers website as a digital photo – for all to see.

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Esther Sirica, 68, was planning to have a surgery performed on her left foot’s hammertoe. She had joined a swim club for seniors and wanted to show off her feet. “I’d always wanted to be a foot model when I was younger,” she explained, “in my day; a well-turned ankle was just the beginning.”

But she wasn’t independently wealthy, and there were gaps in her Medicare coverage that she didn’t understand. “When I asked my primary care physician about the surgery, he said that I wouldn’t be covered. “It’s elective surgery on a pre-existing condition,” he asserted. But Esther wasn’t convinced. “Men used to find my feet lovely,” she told her physician, “except for THAT one.” She was pointing to her hammertoe, not the photo of President-elect Obama on the nearest wall.

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Esther quietly demurred amid the usual pleasantries, and begged her leave. A moment later she was off to find a second opinion. Her second opinion, an elderly physician who at least comprehended the surgery’s potential significance to the woman if not its urgency, did recommend the surgery, and perfunctorily checked out Esther’s Medicare coverage. “The surgery will cost $1,750,” he informed her.

“That’s not so much,” she said, assuming it was entirely covered except for her co-pays.

 “But Medicare will approve only about half of that, $825.00,” he added.

“Oh,” she said, with sadness suddenly re-encroaching upon her entire being, including the deformed toe.

Fortunately, Esther’s next visit was to her California health insurance agent, a valuable source for information on Medicare Supplement coverage for the past year or two. The nice young agent there had mentioned something called Medicare Supplement Insurance policies as a way to plug the disturbing Medigaps.

A month later, Esther was in the pool with the seniors, literally a new woman. A gentleman swimmer named Tony was looking at her foot when he noticed it. “Didn’t you used to have a hammertoe?” he remarked.

Esther Sirica flashed a big smile, her dentures clicking.

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Alfred was under the mistaken impression that Medicare was all he was entitled to, gaps and all. His California Health Insurance Agent Matt set him straight.

 Alfred H., age 104, lives in Escondido. He’s been blessed with relatively good health, although he fractured his hip while in an infantry unit, an imaginary one, when he fell out of his uncle’s pear tree, in 1918 when he was only 14.

 Alfred’s wife died in 1980, and occasionally his son Zeke, 73, stops by to visit. Zeke has had a succession of health issues, and retains Matt’s California Health Insurance Services, with Matt Lockard as his agent. Zeke has a Medicare Supplement Plan for 65+ seniors that serve his needs well. But Alfred has no agent and Original Medicare only witch is full of gaps. Suddenly, just in the past few months, his hip has been giving him trouble.

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 “I never saw you break your hip,” Zeke told his Dad, “did you take a fall recently?”

 “Nope,” Alfred said, “It happened before you were born.”

 “That sure isn’t recently,” Zeke agreed. “Are you going to have it fixed?”

 “Can’t,” Alfred said, “My Medicare will only pay for part of it. I went to see the doctor, he said I’d need surgery and the break is still there. In 90 years, it’s never completely healed.” 

 “It might get worse,” Zeke agreed, “you could end up like one of those old men and have to use a walker.”

 “I’m over 100 now, it’s too late. Medicare by itself is the best option for me.”

 “Why don’t you see my California health insurance agent, Matt Lockard?”

 Alfred drove over in his beloved Studebaker that still ran clean as a whistle. He spoke to Matt. Matt helped him understand how Medicare Supplement plans work.”

 The surgery was successful. For the first time in 50 years, Alfred called Lissie up on the phone. He’d known her from way back. “Do you want to go dancing?” he asked her.

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Our services begin with California health insurance plans for individuals and families. A free and accurate instant quote awaits you at MattsInsurance4CA.com. We offer Medicare Supplement Insurance plans to fill in those tricky “medigaps.” Instant quotes are also available for term life insurance, so that your loved ones can be provided for when the time comes. Dental insurance plans can be quite complicated, but we offer dental plans which can be tailored to healthier smiles. Access to reliable health care via child health insurance is a necessary part of any child’s development. But without a reliable plan for your child or children, young people can needlessly be placed at risk. Quotes for child plans are also available instantly on our convenient website. How about medical insurance protecting you or your loved ones when you’re traveling? Matts offers travel medical insurance to citizens of any nationality worldwide. We provide individual or group travel medical insurance for:

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Annual Election Period (AEP)
The Annual Coordinated Election Period runs from November 15 through December 31 each year. Medicare beneficiaries can change Medicare Advantage plans or change their Part “D” prescription drug plan during this time frame. During this time frame a Medicare beneficiary can also choose to return to original Medicare, or enroll in a Medicare Advantage plan for the first time. Enrollment changes take effect on January 1.

Open Enrollment Period (OEP)
The Open Enrollment Period extends from January 1 through March 31. During this time Medicare beneficiaries have one opportunity to enroll in, disenroll from, or change a Medicare Advantage plan. The change in Medicare Advantage enrollment or disenrollment becomes effective the month after the change is made.

Only Medicare beneficiaries who are eligible to enroll in a Medicare Advantage plan may make a change during the Open Enrollment Period. A beneficiary who has both Medicare Part A and Medicare Part B and wants to change must live in the area served by the Medicare Advantage plan.
During the open enrollment period beneficiaries may not add or drop Part D drug coverage. Medicare beneficiaries who already have drug coverage can only change to another plan that provides drug coverage. Medicare beneficiaries who do not have drug coverage may not change to an option that provides drug coverage.

Permissible changes during the Open Enrollment Period include:

-MA-PD to Original Medicare and a PDP
-MA-PD to a different MA-PD
-MA-only plan to original Medicare
-Original Medicare and a PDP to an MA-PD
-MA-only plan to a different MA-only plan
-Original Medicare to a MA-only plan

Beneficiaries who want to use the Open Enrollment Period to return to Original Medicare from an MA-PD must do so by enrolling in a PDP. Enrollment in a PDP during either the Annual Coordinated Election Period or the Open Enrollment Period terminates enrollment in a Medicare Advantage plan. Because beneficiaries are generally limited to changing their prescription drug coverage during the Annual Coordinated Election Period, MA-PD enrollees who want to return to Original Medicare during the Open Enrollment Period have a Part D Special Enrollment Period that allows them to make one enrollment into a PDP.

An overview of the different plan types.

Local HMOs and PPOs contract with network providers to deliver Medicare benefits. In 2008, 68% of all HMO and local PPO plans also offered Part D drug benefits. These local HMO and PPO plans account for 64% and 7% of total MA enrollment respectively.
Private Fee-for-Service plans (PFFS) are designed to allow open access to providers. PFFS plans are not required to establish provider networks, report quality measures, or have Medicare review and negotiate bids. The Medicare Improvements for Patients and Providers Act requires Private Fee-for-Service plans to comply with new quality reporting requirements and, beginning in 2011, to form provider networks in certain counties. From July 2006 to July 2008, PFFS enrollment nearly tripled from 765,000 enrollees to 2.3 million (22% of total MA enrollment).
Regional PPOs were established under the MMA to provide rural beneficiaries greater access to MA plans, with a $10 billion “stabilization fund” to encourage entry of regional PPOs. This fund was virtually eliminated under the MIPPA. In 2008, regional PPOs are available in all but five of the 26 MA regions but account for only 3% of all MA enrollees.
Medical savings account plans (MSAs) combine a high deductible health plan with an MSA into which Medicare makes annual deposits on behalf of enrollees. Beneficiaries draw from these funds to pay for qualified health care expenses until they meet a deductible (ranging from $2,500 to $5,100 in 2008), at which point the plan pays for all Medicare-covered services. In 2008, MSA plans have only 3,529 MA enrollees.

Special Needs Plans (SNPs), mainly HMOs, are restricted to beneficiaries who are dually eligible for Medicare and Medicaid, live in long-term care institutions, or have certain severe and disabling conditions. The number of SNPs increased from 125 in 2005 to 769 in 2008, with 1.2 million enrollees as of July 2008, mainly dual eligibles. The MIPPA reauthorized SNPs through 2010, but prohibits the entry of new SNPs until then.
Other plan types, including cost, HCPP, PACE contracts, demonstrations and pilots, account for 4% of MA enrollment.

For more Information on how to enroll in a California Medicare Advantage Plan call Matt Lockard at 1-866-861-0477.