I am in favor of reforming the way health insurance is purchased and the way coverage is determined. I have been very fortunate for my whole adult life because I've had health insurance coverage — medical, dental and vision — ever since I became of age and married. This insurance was provided as a benefit through my husband's employer, a company where he worked for 33 years and retired with benefits.
I, too, worked and had additional coverage through my employer. I took it for granted that my health insurance would always be there at the same level it had always been.
To my surprise, I found out once I turned 65 and was eligible for Medicare that my private insurance changed for the worse, even though I continued paying for it each month to supplement my Medicare.
I can understand that the federal program tries to contain cost, but why should your coverage be limited to what is approved by Medicare and by the insurance company you pay to cover your medical problems?
To my dismay, I discovered this loophole a week ago, two weeks after surgery. So here I am, three weeks after surgery and two trips to the emergency room with a complication that will require weeks of dressing changes to resolve. These expensive dressings will not be paid for if I opt to do them myself, which as a retired registered nurse I am perfectly capable of doing. So why won't Medicare or United Health Care pay for it?
I had this same problem after two surgeries before I turned 65. In both instances, the insurance company understood it was cheaper for me to do the dressing changes rather than have a nurse come to my house to do them every day. Everything I needed to take care of my wound was paid for by the insurance company and delivered to my house.
This time, because Medicare in this region will not pay for this kind of self care, United Health Care will not pay for it either.
How do I solve this? In the most expensive way there is.
My doctor will request home-health nurses. The nurses will come to my house every day, and Medicare will pay for the service. United Health Care will pick up the difference.
This is costly and stupid.
I am not the only senior who is in the same boat. I wonder just how many seniors in this region are shouldering this expense. Because wound care is not a cheap problem to deal with, it is possible that some seniors might be scrimping on the number of wound dressing changes they are doing, possibly putting themselves at risk for additional post-surgery complications.
Seniors deserve better, and we all need better service from our insurance companies.