The interview was conducted over the phone with a 74-year-old female living in a rural community. When asked which Medicare components she currently subscribes to, the response was Medicare Part A and Part B. She indicated moderate satisfaction with her Medicare benefits, although complained that for someone living on a modest fixed income, the co-pays were challenging to meet. She has been a Medicare beneficiary for about 9.5 years.
I next asked her about Part A and Part B, including what those parts of Medicare covered. She said her understanding of Part A was that it was primarily for crisis care if she has to go to the hospital. Medicare (2017) indicates that this is true, but that it also covers a limited amount of skilled nursing facility care, nursing home care, hospice, and home health services. I then asked about Part B and what she thought it covered, and how much she paid for it. She said it covered doctor visits and vaccinations. According to Medicare (2017), this is basically true, but is incomplete. Medicare Part B also includes diagnostic services, ambulances, medical equipment, and second opinions. She was unclear about what she paid for Medicare Part B but thought it was about $100/month, less than what some others who enrolled in the past couple years. According to Social Security (2017) the average recipient of Social Security pays about $109/month for Medicare Part B. I also asked if she had Medicare Part D for prescription drugs. She does not have that coverage from Medicare.
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She told me she was a member of the Humana Advantage Medicare program. Where she lives in a rural area, this has a zero premium beyond what Medicare Part B costs. Her program limits her to a specific network of doctors and hospitals, but that network includes her favorite doctor, the hospital that’s only a few miles from her house, and the most respected medical network in her area. It also includes a variety of other benefits. According to Humana (2017), she pays a $10 doctor visit copay, gets an eyewear allowance, and has very inexpensive prescription costs, especially if she uses the mail-in pharmacy. She thinks it also has some hearing benefits beyond Medicare, but was unclear about the specifics of those benefits. I also asked how satisfied she was with that particular Medicare Advantage plan, and she said she was moderately satisfied. She might change to a different Advantage plan next year when the open enrollment period starts. She expressed unhappiness with having to research the best plan for her every year. It was too time-consuming and confusing, in her opinion, but the details of the plans change so much from year to year that she found it necessary. Finally I asked her if she had other supplementary healthcare insurance, and she said she did not. I thanked her for her time and we said a cordial goodbye.
- Medicare. (2017). What Medicare covers. Medicare.gov Retrieved from: https://www.medicare.gov/what-medicare-covers/index.html
- Humana. (2017). Humana Medicare Advantage Plans. Humana.com. Retrieved from : https://www.humana.com/medicare/products/medicare-advantage/
- Social Security (2017). Medicare. Social Security Administration. Retrieved from: https://www.ssa.gov
