Saturday, September 5, 2015

Medicare Primer: Advantage or Medigap?

“…The following compares the primary advantages and disadvantages of traditional Medicare and Medicare Advantage plans. But everyone is unique, and it’s impossible to simplify a process that requires each individual to research his or her best options, based on the severity of their health issues, their preferences and financial situation, and the policies available in their state’s insurance market.

“Monthly premiums are the easiest information to compare, and cash-strapped retirees too often base their decisions largely on the premium they’ll have to pay every month. But potential out-of-pocket costs, such as copays and deductibles, might ultimately prove more important, especially as retirees age and are more likely to incur high medical bills. Considering both the premiums and out-of-pocket costs complicates the choice between lower-premium Advantage plans and higher-premium Medigap plus a prescription drug option.

“Part A hospital coverage is free for most people, but everyone enrolled in Medicare pays the Part B premium – the base amount is $104.90 per month in 2015, but higher-income people pay more – which covers doctor visits, outpatient care, lab work, scans, medical equipment and other services.

“In traditional Medicare, beneficiaries pay deductibles and co-pays, typically 20 percent for office visits and other Part B services, and the program does not limit out-of-pocket spending by beneficiaries. Medigap plans – also known as Medicare Supplemental Insurance – cover some or all co-payments and deductibles, and about one-third of traditional Medicare enrollees have Medigap, according to Kaiser. Premiums average about $200 per month and can go as high as $500 and do not include prescription drug coverage. Most people who choose traditional Medicare get a Part D drug plan, which averages $38 a month.

“Growing numbers of Medicare beneficiaries are flocking to Advantage plans (also known as Part C), because the additional premium for these plans, on average about $41 a month for plans with prescription drug coverage, is much lower than premiums for a supplemental Medicare Part D prescription drug plus a private Medigap plan. Advantage plans, typically offered by HMOs, limit out-of-pocket costs to $6,700 or less annually and often provide prescription drug coverage. A 2013 study by Kaiser found that the vast majority of Medicare beneficiaries have access to at least one Advantage plan in their area that includes prescription drug coverage but only half choose them.

“The bottom line on premiums: the average Advantage Plan premium plus the Part B premium equals $146 per month, when prescription drug coverage is included. This is half of the $343 in total premiums a beneficiary would pay for the Part B premium, plus a Medigap and a Part D drug plan, according to Kaiser’s estimates...”

For the entire article, click here.

Friday, September 4, 2015

Two Poems by Mark Strand


The Continuous Life

What of the neighborhood homes awash
In a silver light, of children hunched in the bushes,
Watching the grown-ups for signs of surrender,
Signs that the irregular pleasures of moving
From day to day, of being adrift on the swell of duty,
Have run their course? Oh parents, confess
To your little ones the night is a long way off
And your taste for the mundane grows; tell them
Your worship of household chores has barely begun;
Describe the beauty of shovels and rakes, brooms and mops;
Say there will always be cooking and cleaning to do,
That one thing leads to another, which leads to another;
Explain that you live between two great darks, the first
With an ending, the second without one, that the luckiest
Thing is having been born, that you live in a blur
Of hours and days, months and years, and believe
It has meaning, despite the occasional fear
You are slipping away with nothing completed, nothing
To prove you existed. Tell the children to come inside,
That your search goes on for something you lost—a name,
A family album that fell from its own small matter
Into another, a piece of the dark that might have been yours,
You don't really know. Say that each of you tries
To keep busy, learning to lean down close and hear
The careless breathing of earth and feel its available
Languor come over you, wave after wave, sending
Small tremors of love through your brief,
Undeniable selves, into your days, and beyond.

Lines for Winter

Tell yourself
as it gets cold and gray falls from the air
that you will go on
walking, hearing
the same tune no matter where
you find yourself --
inside the dome of dark
or under the cracking white
of the moon's gaze in a valley of snow.
Tonight as it gets cold
tell yourself
what you know which is nothing
but the tune your bones play
as you keep going. And you will be able
for once to lie down under the small fire
of winter stars.
And if it happens that you cannot
go on or turn back and you find yourself
where you will be at the end,
tell yourself
in that final flowing of cold through your limbs
that you love what you are.

Mark Strand is the author of 18 books of poetry: Sleeping with One Eye Open, Stone Wall Press, 1964; Reasons for Moving: Poems, Atheneum, 1968; Darker: Poems, Atheneum, 1970; The Story of Our Lives, Atheneum, 1973; The Sargeantville Notebook, Burning Deck, 1974; Elegy for My Father, Windhover, 1978; The Late Hour, Atheneum, 1978; Selected Poems, Atheneum, 1980; The Continuous Life, Knopf, 1990; The Monument, Ecco Press, 1991; Reasons for Moving, Darker, and the Sargeantville Notebook, Knopf, 1992; Dark Harbor: A Poem, Knopf, 1993; Blizzard of One: Poems, Knopf, 1998; 89 Clouds, ACA Galleries, 1999; Man and Camel, Knopf, 2005; New Selected Poems, Knopf, 2007; Almost Invisible, Knopf, 2013; Collected Poems, Knopf, 2014.

His poems have been published in various periodicals such as Poetry, Agni Review, Boulevard, London Review of Books, Partisan Review, The New Yorker, Indiana Review, Paris Review, Oxford Quarterly, American Poetry Review, and many others.  Among his many awards and honors include the Pulitzer Prize for Poetry in 1999 for “Blizzard of One.” Strand was the US Poet Laureate in 1990-91. He was also an editor, translator, prose writer, children’s book author, and art critic.

Mark Strand 1934-2014