Medicare Enrollment: The Tale of Duncan and the Donut

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Duncan and the Donut

By Susan Goldfein

Ah, October: Columbus Day, Halloween, the World Series and for those of us who are late-middle-aged, the start of Medicare open enrollment season and worry about The Donut.   

If your age is at, or exceeds, the speed limit, you have approximately two months to reassess your prescription plan. This season I resolve to finally become a more informed consumer, and seek a comprehensible explanation of the arithmetically baffling “donut hole.”      

Who’s Duncan and does he work with donuts?

I breathe deeply as I dial the 800 number that will hopefully provide answers before dinnertime beckons. After I assure the disembodied voice that I’m OK with English, she inquires about the purpose of my call. “Explain the donut hole,” I reply. “OK,” says she, “I’ll connect you to a representative.”   

Educate yourself about the Donut Hole
Educate yourself about the Donut Hole

The music swells, occasionally interrupted by a reassuring message regarding the importance of my call. And the longer I’m forced to listen, the more I remember why I chose to live in ignorance. Finally, the welcome click, signaling the end of the sound track, and connection to a human. 

“Hello, welcome to the ‘Donut Hole Customer Care Line’. My name is Duncan. How can I help you today?” 

“Surely, that can’t really be your name,” I gulp, trying not to giggle. 

“Yes, ma’am, sadly it’s true. I’m Duncan, the donut hole specialist, and I would appreciate if you could please refrain from making jokes and cheap puns, or referring to me as a Munchkin.” 

Image from BoomerBenefits.com

“Never entered my mind,” I assured him, crossing my fingers. “I simply want to know how to avoid falling into the donut hole.” 

“You can’t avoid it,” Duncan said. “Once you reach your coverage limit, down you go. You’re on your own until you’ve hit your TrOOP.”   

My troop?  It’s been years since I’ve been a scout leader.  And I can’t afford to be on my own.   

After Duncan explains that TrOOP is an acronym for True Out-of-Pocket expense, I whine into the phone, “Isn’t there something I can do?” 

Duncan pauses. “Well, you can remain healthy, or take a second mortgage on your house. If you would like, I can transfer you to the Second-Mortgage Donut Hole Help Line.” 

Duncan must have sensed my despair because he lowered his voice and, in a confidential tone, asked me if I’d considered moving to Canada. 

I hung up, more confused than ever. But not before I told Duncan that I “donut” know how to thank him. 

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