Tuesday, March 16, 2021

Medicare and Me

I've recently noticed that my brain-mouth duo has been liberated. For sure, I'm no Polyanna, but I'll maintain that that's a good thing, the liberated brain-mouth, that is, not the Polyanna reference. In reality, invoking "Pollyanna" raises alarms these days, at least in psychotherapy circles where they talk in terms of syndromes; the Polyanna Syndrome refers to an unwillingness or inability to accept that sometimes, yes, life sucks and you need to embrace the misery that accompanies tragedy; let your grief carry you. . . naturally. Those who suffer from "polyannaism" - if each of us thinks real hard we can identify at least one person in our lives who exhibits signs of it - have the tendency to re-cast negative events in a positive, but unrealistic light. It's interesting to note that, for Polyanna types, memory of a past event is more likely to be skewed if it was a negative experience; memory is much more accurate when it involves a positive experience. This is how you can tell whether a person is just generally an optimist, coping with life in a healthy way, or someone who truly is a Polyanna, incapable of confronting adversity, thus short-circuiting the body's (and mind's) ability to heal. One final note: a condition such as this can affect not just one's ability to be consoled, but one's ability to console.


Returning to my liberated brain, my entrenched habits of censoring my thoughts have been shattered, and now a steady stream of musings and opinions are tumbling forth. At this particular moment I blame it on Medicare, and why not? They're in my cross-hairs. After contributing for decades, if not generously, at least with a minimum of (pointless) protest; I have signed up. If my age (something that I'm fairly good at remembering) weren't a signal that I needed to take care of the paperwork involved, my impossibly overburdened mailbox served as a considerate reminder by daily vomiting flyers from AARP, Tufts, Blue Cross Blue Shield, Aetna, etc.


The first thing I notice is that I'm paying more for health insurance. I won't get into the government's characteristically polite, even affectionate, and cleverly worded letter as to why this is so, other than to say that it included fun acronyms like "MAGI"* and "IRMAA"**, and assurances that if my subsequent levels of income should go into free fall, I was free to ask them (not even sure I know who "them" is) to re-assess my ability to pay additional premiums. The short of it is, I'm on a fixed income and I don't like surprises of this sort. I never saw myself as the type who would rail against this kind of injustice; no, I would join the ranks of retirees with grace, composure, and bonhomie; you'd love having me in your midst. 


I don't think I'm especially daft when it comes to educating myself about matters that involve health or fixed costs or both of those ideas together. My good friends Linda and Ann, over the course of several dinner dates, tried to simplify Medicare for me. Finally, they just pulled their cards from their wallets and tapping each one as illustration, said, you need Parts A & B (this card right here), and Prescription coverage (this card right here). Or maybe they said, you need Parts A & D, or Parts A & C, or just Part D but only if you were born on Friday the 13thor maybe they just said sign up for everything that arrives via U.S.P.S. or email; that way you’ll be covered.  And my cousin Beth cautioned: make sure you do that at precisely 0000 hours exactly 3 months before you turn 65.  The promised penalties if you don’t comply are considerable; the Social Security Administration is quite clear about that.  For those who play fast and loose with the SSA’s rules, you’ll know that they mean business when they send out a U.S. marshal armed with a rifle with bayonet attached.

 

So, it’s been fun turning 65.  I’m looking forward to thumbing through my wallet, lifting my shiny new Medicare card and slamming it down on the counter the next time I find myself in a doctor’s office or at the Registry of Motor Vehicles or upon arrival at the National Zoo.  I mean, I paid enough for that membership - I should get something good out of it.

 

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*Here's an important lesson for anyone who draws a paycheck legally in this country. One of the greatest betrayals for the novice wage earner is a mythical figure called "gross income". It represents what you innocently think you'll be earning. My best advice to a person upon receiving their very first paycheck is to sit down before taking a look at it, preferably in front of a computer with internet connection; it's a shocking experience that will make you lightheaded, and one that persuades you to do a google search of "lowest income tax countries". (I've done the work for you; oil-rich Qatar or the tourist-pleasing Bahamas might be options). No one asked you if you wanted to set aside a certain percentage for the more challenging days of retirement. . . which keeps moving further away in the future. No one asked you, either, if you wanted to share some of your earnings with your state - to do with as they deem necessary - and with the federal government - to do with as they, too, deem necessary. 

 

While there’s no profit in protesting the unattainable nature of gross income, as April 15 approaches, we warm to the idea of “adjusted gross income”.  Reassured by the promise that it can never surpass gross income, the objective is to make AGI as different from gross income as possible.  The real evil-doer is “modified adjusted gross income”; the diabolical MAGI takes your adjusted gross income and ADDS BACK IN the deductions you could claim.  The first question you should ask here is, why is there such a thing?  MAGI is used in order to limit participation in the Government’s “benefit” programs or to prevent you from contributing to a Roth IRA, as well as deducting for contributions that you made to your IRA.  

 

**The final indignity is IRMAA.  Simplified, “Income-Related Monthly Adjustment Amount” is the Government’s way of saying, Hey, Joyce, we know that you and your husband saved, saved, saved throughout your working years, eschewing all manner of vacations and splurges, instead investing wisely; we now want to reward you by charging you more for your Medicare coverage. (Right about now I have a rather impolite response to that; I have faith that I don’t need to say it out loud.)

 

The bottom line is, the Government is always going to get its money; it’s too impatient to wait around till YOU say you’re ready to pay taxes.  Moreover, once they’ve wrested those dollars from you, that fist closes tight around them.  So, I’m wondering about what lifestyle changes I’d have to make in Qatar?  It might be nice not to have to adorn my front step with a shovel and a bucket of ice melt 8 months of the year.  But, what about the Bahamas?  Are hurricanes a chronic threat?  The island life does sound appealing.   Hmmmm….. so much to think about.

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