Kathleen Rhodes

As an insurance agent in the Medicare field, it is my responsibility to stay abreast of new plans for Medicare recipients with "chronic conditions." In short, these plans provide special benefits for people with heart disease, end stage renal disease, diabetes and a few others. The idea of designing plans around a member's specific health issues, especially when these are severe, is a good one, and is necessary. Of course, we all want our unhealthy family members, friends, neighbors, and co-workers to have as much help as they can get so that they don't have to worry about major financial challenges on top of the effects of their illness.

But I notice there is a rather large gap when it comes to how Medicare identifies what constitutes "chronic conditions." Before being an insurance agent, I am also the daughter of two parents with Alzheimer's disease and dementia. Being a caregiver to someone with this particular disease is difficult in many ways. I am certain anyone reading this knows or has known someone with Alzheimer's. The decline is both heart-breaking and difficult to understand. No one wants to sit back helplessly and watch someone they care about become non-verbal, incapable of self-care, and as I have seen, no longer aware of who I am when I walk into a room.

On top of the obvious grief and sadness this illness causes, there is also a major problem with the way families and caregivers are expected to pay for the effected person to get the help they need. Medicare does provide benefits for long-term care, but only for a certain number of years. Furthermore, home health aids and hospice are covered, but in many cases, not for the length of time the ill person lives. My father has been living with Alzheimer's for 12 years. His care has not been covered for the past 5 of those years. To keep him in a locked facility where he is safe, per month, is over 5 times the amount of my monthly incoming. When the money runs out, we cannot bring him back home to care for him ourselves, as we are working during the day and have no Medical training.

Many families turn to Medicaid or other state assitance to help with expenses, but it is not a guarantee to be accepted. It can feel like the powers that be in the Government get to decide how much care a person should need and for how long. So what can we do? Millions of families are suffering silently from the emotional and financial affects of Alzheimer's disease, and there are simply not the resources available to help those who bare the burden of these costs. Private organizations, while valuable, do not compare to those who help with, for example, cancer.

I challenge Medicare to create Chronic Special Needs plans for members suffering from Alzheimer's or severe dementia. Studies should be conducted to see what forms of therapy and medical care these individuals need, and work toward mitigating the financial burden on those who care for them. Furthermore, these plans should include new medications on their formularies so that they can be used over time if they show promise. Of course, I fully support that Medicare has tailored plans for other life-threatening illnesses, but Alzheimer's disease seems to have gotten lost in the shuffle, despite how common it is. For a disease with such emotionally costly effects, let us help caregivers afford the financial impact, so that we can concentrate on spending the valuable time we have on what is most important. We cannot always help these members recover their memory, but let us in the insurance industry show that they are not forgotten.

In the complex world that is Medicare Insurance sales, I have at times felt like I were going down a rabbit hole. Trying to absorb all the ins and outs, the rules and the exceptions, was overwhelming and I questioned whether it would be worth the effort. Also, everything in the field is constantly changing. We get accustomed to the products and benefits for one year, only to find that it is time to do the same for the next year. I currently work with 8 different Medicare insurance carriers, and at times, I find myself caught up the numbers, the percentages, the copays, the premiums.. and it seems to never end.

The industry can often feel very lonely as well, with everyone seemingly fighting over leads and trying to stand among a large group. I would even describe it as cutthroat at times, especially during our major enrollment periods, where the bulk of what earn as agents and brokers is made. Sometimes I think I do not belong, because ever since childhood, I have been a shy, sensitive and some have even said a “people pleaser.” I do not always succeed in a competitive atmosphere, where many of my colleagues seem to thrive.

Then there are the dollar signs. I remember, as a new hire at my company, carefully studying commission tiers to see what I would earn with a certain number of enrollments per week. It was like playing chess in a world where I would rather be playing something more collaborative. Of course, I chose this career to make a living, but I have had to check myself every now, and then to remind myself that this is the real world, a world full of people in need of better coverage for their healthcare needs, and a world full of people to whom you may be the only one a caller speaks to in the course of that day.

So, we must not lose sight of what we are really doing when we make or receive a call from someone in need. These leads we talk about so much are real people, all of whom have an important story to tell us. It is my loyal clients who keep me going when the rest of my field can feel overwhelming. It is satisfying to make enrollments, but there is nothing better than, at the end of a call, the person on the other end of the phone is tears because they are relieved, or when someone says, “You’re the first person willing to listen to me and help me.” That is where the true satisfaction lies, if I can lay down to sleep at night knowing I have made the lives of those I interacted with just a little bit easier.

Overall, the world of Medicare insurance sales should be tailored more toward learning more about the people we help, and not a potential commission. I will never be that kind of agent, no matter what the pressures are to do so. A rule that I have followed throughout my career has been to never recommend something to a perspective beneficiary that I would not want for myself or my parents, and I hope I never lose sight of that.