Posts Tagged ‘Medicare’

Take Me Out of the Ballgame

Friday, May 22nd, 2009

An 86-year-old cantankerous man’s worst fear is realized when he goes to his first Major League Baseball game and gets hit by a foul ball, but insurance obtained from a California Health Insurance agent softened the blow.

Dodger Stadium

Dodger Stadium

Mickey Moosaka’s nephews and nieces were at their wit’s end. What activity would their cantankerous grand-uncle agree to participate in that the entire family might attend? He’d turned down bowling. “It reminds me of pinheads,” old Mickey said. He avoided restaurants. “Flies and their eggs on every plate,” he said, sickening anyone within earshot. Miniature golf emphasized the codger’s recently shrunken stature. “Don’t belittle me by taking me to a place like that,” he’d said to his thrifty niece Sappy in his rather squeaky Buster Brown voice. It was decided that “Uncle Mickey” would take in a Dodger game at the Stadium. Above all else, he enjoyed baseball, despite his consummate fears. He finally relented but warned, “I’ll probably get bonked by a foul ball off the bat of Manny Ramirez.” The geezer was a lifelong Dodger fan but had never been to a game in person.

The Moosakas got a nice row of boxes not far from home plate but well back in the upper deck. The seats seemed relatively safe. “These are great seats, huh Grumpa,” chirped twelve-year-old Matty to his beloved great-great-uncle. Matty was in his last year of Little League and played all-star caliber shortstop on a junior version of the resurgent Dodgers.

Fifty or sixty foul balls came and went, a few coming close, within a few rows, by the sixth inning, when the famous Dodger left fielder approached the batter’s box. “He’s going to conk me with a foul ball,” Mickey Moosaka predicted. The first pitch to Manny Ramirez was a fastball, which he took. The next two pitches were outside, so the count was 2-and-1 when the fateful pitch came. “This one hits me, I know it,” wailed old fearful Mickey. “No, it won’t,” said Sappy, fast becoming Mickey’s least favorite niece. “You worry too much.” But the next pitch, a curveball, was fouled back on an ominous trajectory. It seemed like the ball had eyes. Sure enough, it smacked old Mickey on the forehead with tremendous force, knocking him cold. Carried out of the ballgame on a stretcher, he was taken to the nearest hospital.

But Sappy was no sap. “Thank God we already had accidental coverage from a California Health Insurance agent,” she said. “It didn’t cost us a cent.”

“Thank God Grumpa Mickey didn’t die!” wailed Matty, placing priorities correctly.

“I guess,” Sappy was forced to agree.


Health insurance doesn’t automatically lead to health care

Tuesday, April 21st, 2009
Matts California Health Insurance
I found this at http://www.kevinmd.com/blog/
Well said.

NYU’s Marc Siegel writes a poignant op-ed in the Wall Street Journal, echoing much of the sentiment on this blog.

“With more and more doctors dropping out of one insurance plan or another, especially government plans,” writes Dr. Siegel, “there is no guarantee that you will be able to see a physician no matter what coverage you have.”

He goes on to cite the depressing statistics, including the fact that more than half of primary care doctors in Texas refused Medicare, and that 28 percent of Medicare beneficiaries nationwide had trouble finding a primary care physician.

If universal coverage is enacted, especially if it includes a public option, more patients will be creating demand for government programs that doctors are rejecting in droves.

The result? “The doctors that remain in this expanded system will be even more overwhelmed than we are now.”

I have a similar take, which I expressed a few months ago in the NY Times’ Room for Debate Blog:

So, while any attempt at covering the millions of Americans without health insurance is a laudable goal, doing so without addressing a health care system ill-equipped to deal with millions more patients has the potential to make an already grim situation worse.

I’m happy to see that others are seeing the problem the same way.

The Ins and Outs of Medigap Coverage

Friday, December 5th, 2008

Filling in the Medicare gaps can be tricky business for seniors, but it can be done with a little help from your California Health Insurance Agent.

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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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