This is not a random post. Please – allow me to explain. As a citizen of the greatest country in the world, (My apologies to all non-Americans. I am sure you feel the same way about your country, as well.) I have expectations and dreams, like everyone else, when retirement comes knocking on my door. Call me a dreamer, but isn’t Medicare supposed to be a good thing? Aren’t we supposed to be able to rely on this system when we retire? The good news is that we can – as long as we need surgery and medication.
I took my mother to the ear doctor today. He didn’t tell me anything I didn’t already know. After a complete audiogram, the results indicated she had moderately severe hearing loss in both ears. I knew this already! Everyone in my family can testify to my mother’s hearing loss! She needed to hear it directly from the doctor, though. That’s how she is. Unless the doctor has spoken, it goes in one ear and out the other, so to speak.
On behalf of the doctor, he treated my mom with genuine respect. He was kind, courteous, funny, and made her feel at ease. After all, she’s an octogenarian. Not everyone makes it to 80 years old and still has their wits about them. She does, however. Sharp as a whip, that mother of mine! She can work a smart phone better than anyone her age! We like to kid her and tell her that all those years of games and puzzles have paid off in her twilight years.
There’s probably some truth in that, isn’t there? The brain needs exercise too, like every other muscle and organ in our body. But, I digress. The doctor told my mother that there was no magic pill or surgery that could fix her problem, which caused me to start thinking about his statement. More on that statement in a minute. The solution? A very expensive hearing aid. Here’s the problem with that.” Medicare doesn’t cover routine hearing exams, hearing aids, or exams for fitting hearing aids.” (http://www.medicare.gov/coverage/hearing-and-balance-exam-and-hearing-aids.html) I was deeply discouraged when I discovered this information. There was good news, however. My mother has secondary coverage. So I called her secondary provider and learned they would pay up to $1500 for the cost of one hearing aid. I asked many questions to the young lady at the secondary insurance company. At the end of the conversation, I was absolutely guaranteed a $1500 benefit from her secondary insurance company. I became so excited, I promptly told my mother the good news. She was elated and near tears at the thought of being able to hear at a normal range again. She lowered her head and her voice became shaky when she said, “Oh good. I’ll be able to hear again. That’s great news! My mother is a very proud woman. She doesn’t want a hearing aid! She doesn’t want to burden anyone either. She is a very strong-willed woman, who has been taking care of herself her whole life. She didn’t want me to see those tears. I understood completely, as the apple didn’t fall that far from the tree. Needless to say, I was excited for both of us. The doctor’s visit had estimated that the cost of the hearing aid would be approximately $1500. It seemed the cost of the hearing aid would be covered and my mom would soon be enjoying the necessity of a good ear once again. Then, I called the doctor. My phone call was routed to the audiologist, instead. Her telephone voice was calm, kind, and firm. I gave her the good news. Then, she gave me the bad news. She told me that my mother would have to pay for the hearing aid up front. My heart sank. I became very upset. I kept my emotions to myself temporarily. I asked the audiologist why my mother should pay for it first if the insurance company is going to pay for it. She explained that the doctor’s office pays for the devices in bulk, or “large invoices,” as she put it. She said that their experience has been that insurance companies frequently offer to pay “up to $1500” for hearing aids. She said that whenever they say “up to,” it usually means they are only going to pay for a small portion of the cost. I reassured her that I asked the insurance company several questions, including “exactly” how much they would pay for a simple device. She continued to say that they usually pay 1/3 of the cost and because the doctor’s office doesn’t bill balances to the patient, they have lost a lot of money. At this point, my emotions ranged from disappointment to anger. I’m not exactly sure who I am angry with – the doctor or the insurance company. Maybe I feel angry at both of them. I am thinking about my mother now, as the audiologist apologizes for company policy. I don’t want to be harsh, as she does not make the company policy, but at the same time, an apology is not going to get my mother a hearing aid. She doesn’t have $1500 to give to the doctor up front. That’s why she paid for insurance her whole life. Why should she suffer because a) the doctor’s office buys the devices in bulk, b) some insurance companies don’t deliver, and c) some people don’t pay their bills. I don’t understand the office policy. I understand finances and overhead. I even understand corporate economics. I worked on Wall Street for 12 years. I get it. What I don’t get is why an otolaryngologist expects an 80-year-old woman to pay for her simple hearing device up front. This hearing device is at the bottom of the device pool. It’s not even the expensive one that comes with all the bells and whistles. My mother raised eight children, almost by her herself. She was raised in an orphanage and began working when she was 17 years old. She has paid into Medicare for 58 years. Let’s say she only paid $25 a week into the retirement coverage. It’s way more than that, I can say, but let’s just be hypothetical and kind for the sake of argument. She has always had a job. Therefore, that would be a grand sum of $75,400 paid into Medicare in her lifetime. We all know this is a ridiculously conservative figure. Most of us pay twice that, if not more. You would think that at the ripe old age of 80, Medicare could afford to buy her a hearing aid. Even though her secondary coverage has offered to pay for it, the doctor will only supply a hearing aid if she pays for it beforehand. What’s wrong with this picture? Anyone? After some research, I quickly learned that hearing aids are not the only necessities Medicare doesn’t cover. Look at the following list that Medicare does not cover. Examine it closely!
“Some of the items and services that Medicare doesn’t cover include: