Tuesday, July 28, 2026

Medicare Advantage is here--and it's a small world after all

Here it is, my "Welcome to Medicare" letter from UPMC Health Plan and Medicare Advantage card.  Two weeks ago I spoke with Virginia, an independent Medicare agent and it couldn't have gone better.  

Virginia said I could come to her office, she could come to my home, or we could have a Google Chat (like Facetime) on our tablets.   

I elected to do the online meetup, though I still ran in the bathroom and shaved and combed my hair before we got things started. 👨

She asked me how old I was, I said I was turning 65 in 3 months.  She told me the first thing I had to do was go to Medicare.gov and enroll.  She could walk me thru it, but we wouldn't be able to continue until I got my card in the mail.

I said I applied for Social Security in January, which automatically enrolled me in Medicare and I already got my card a couple weeks ago; did she need the number?  She said "I have a feeling you're going to be my easiest client today."

I told her I had several Medicare Advantage plans already selected from 3 different insurance carriers:  Aetna, Highmark, UPMC.  She asked if I had any recent medical history and I said boy, do I.  Two operations in June, one on my liver's bile ducts and then a gallbladder removal.

She asked if I knew how much my out of pocket costs were, after insurance.  I told her $880.00 (including ambulance).  We determined that Medicare thru UPMC was closest to my current insurance plan--and my familiarity with UPMC hospitals made them the preferred choice, so I wound up going with UPMC for Life HMO Premier Rx.

After we did the electronic signatures and everything, Virginia asked about my ice pack (I was occasionally holding against the side of my face) and asked if I was suffering with a migraine or allergies.  I told her I had long covid, a chronic inflammatory condition.  She said "I'm so sorry!  My sister-in-law has long covid!"

That's when the conversation got interesting.  Her sister-in-law got LC in 2022 and was forced to take a leave of absence from her job as a school teacher.  After 2 years, she was hardly any better but was close to 60 so she retired early instead.  

Like myself, Virginia's sister-in-law gets hopeful days here and there, but the relapses just keep coming.  She doesn't see an end in sight.  I told Virginia it does feel hopeless at times but you have to believe it will end sooner or later.

One thing I appreciated, Virginia complained her glasses were bothering her nose and she had to get a new pair soon.  I said I did too, mine fit fine but were 8 years old.  After we hung up, she called me right back and told me to hold off on those glasses a little bit longer, I'd be getting a Flex Spend card soon I can use towards them.  Works for me.

Well, I almost didn't blog about this (it's boring, I know).  But I'm glad I did---when I was inspecting my Medicare card to see what to gray-out before sharing, I noticed it said "NO PCP SELECTED" on it and I did give them my new PCP, Dr. Cole.  I just called and reported this, they said "Someone messed up, you'll get a new card in 10 days."   Not exactly a great start, UPMC!

Here's Dr. Cole's photo.  He's a handsome devil, but very smart and very kind.  I like him a lot.

24 comments:

  1. Hi Doug,
    Virginia sounds like a super Medicare agent; she's very knowledgeable and helpful. You're in good hands. Looks like it'll be smooth sailing despite the little goof ups along the way. Take care.
    Steve from Toronto

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    1. Thank you Steve, I know you don't have to worry about things like Medicare as you're in Canada. Does anything change for you after you turn 65?

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    2. I don't know what changes there'll be regarding things medical, but I sure do look forward to paying less on public transit, admissions, etc.
      Steve

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    3. Haha Steve me too! I just called PATransit on Friday to see how to get my FreeRide card. 🙂

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  2. I had a very helpful Medicare insurance expert guide me through the process as well. John had already been through it so he had some advice too. It's an adjustment and not much cheaper for me than my private plan--but covers more. Part of the cost is that I fouled up and ended up in a higher up category for premiums, ugh! For John, who paid $10 a month for his Boeing insurance, it was a lot more to pay! He was shocked. So, your long covid has been acting up lately? :(

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    1. Thanks for sharing Margaret, how did you wind up in a higher up category? Because of income levels? I need to look into that... and yes, the long covid returned 2 days after that lunch outing on July 15. It varies in intensity throughout the day. I am bummed about it. :^(

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    2. Dang it, Doug! It's such a stealthy disease. :( I gifted too much to the grandsons which necessitated selling some securities. I thought I was still under the threshold, but the capital gain pushed me over the limit into now paying more for my premiums for a couple years. Hopefully, not too long.

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    3. Thank you Margaret, I just have to keep hoping it goes away. I went into full remission last summer, a little over 3 months until 4 shots of Novocaine to my mouth did a full relapse. Crazy, can't explain it. And yep, what happened with your premiums, exactly what I thought. This government... God forbid you do something nice for your loved ones!

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  3. It was great to hear about Virginia! She sounds like a most excellent customer service person. What a gem! Sorry you still need that ice pack but happy to hear you're still feeling positive.

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    1. Thank you Bobi. I'm glad to hear from you, thinking of you today around noon, watching Part 1 Jury Duty on Family.

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    2. I've never watched that show but I looked it up and I now I know why!😊

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    3. It is a tough 2 part episode!

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  4. Don’t you love it when a plan comes together?

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    1. I do Peter, I have been fretting over this the past year...

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  5. So glad you were able to find the right person to guide you! I think doing your homework ahead of time really helps too. My husband and I started about 18 months before he retired (I had retired early to take care of my parents and stayed on his insurance) meeting with his union rep, his pension reps, the insurance people his union recommended and going to seminars related to his employment and retirement. It is a complicated system and there is no one answer for anyone. It sounds like you did everything right.
    And your doctor is pretty handsome! He sounds pretty smart too.

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    1. Thanks very much Miss Merry, but compared to you I am strictly an amateur! I was fortunate to have a long history with UPMC insurance for the last 27 years, so I was already leaning towards them. I think my main goal was just finding an advantage plan that was similar as possible to my current insurance. And yes that doctor is pretty handsome, haha! He really is though, a very decent guy.

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  6. Congrats Dug on getting all that settled. With your history with UPMC, it certainly sounds like you made the right choice. And I do think there will be an end with your LC. I'm praying for it and with all the research going on, there has to be. And I'm glad you have a doctor that you like and trust.

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    1. Thank you Rian, I always like your feedback so much. Wish there was an answer for the LC, I've stopped using the nicotine patches--I have a feeling they were antagonizing it. Back to the drawing board..

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  7. I really admire the way you are preparing so throughly! Interesting about the nicotine patches...I was chatting with a friend who had tried them and had all kinds of weird reactions and ended up discontinuing them, too.

    Cheers!

    Ceci

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    1. Thanks Ceci, and I appreciate you sharing your friends reactions to the patches. I felt bad for giving them up after 5 days, this helped.

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  8. -I have to say, having to find the right Medicare package sounds very complicated and difficult. It makes me grateful that we have universal healthcare here in Canada, at least for now. There is a lot of push from certain provincial governments towards private health care, including my own. We have our own problems, long wait times, less access in the rural areas, and limited number of specialists. But I don't have the headache of finding the right insurance.

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    1. Thanks Maebeme--I was just talking about yourself (and my friends Robin, Steve & Florence, you're all from Canada) about this very thing last night. I know no system is perfect, but Canada's has always been more progressive and humane than ours, and I hope it stays that way.

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  9. Hi Doug, I am glad you were able to get everything worked out so smoothly. As Maebeme stated Canada does have it’s problems medical care wise but no where is perfect.Dentistry is VERY expensive here. Chuck was a federal employee for forty years and the maximum insured amount allowed is $1500.00 a year. With Chuck’s implant this spring he blew through that pretty quickly. If you strictly just get a few cleanings a year you are fine. Wonderful you have found such a kind, caring doctor. Take care Doug.❤️❤️

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    1. Thank you Robin, I'm glad to hear from you and thanks for sharing the dental issues there. I hope Chuck's implant is behaving. I must admit I envy him, I need 2 implants and have the funds for them, but I absolutely cannot pursue any dental work. I did last Sept and it took my LC out of remission. I don't know what to do for the time being. Anyway, good to hear from you my friend. 🙂❤️

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