Tuesday, July 4, 2023

My First Amtrak Trip: It Went Well

On Friday, June 23rd, 2023, I took my first Amtrak passenger train trip. It went well.

My train, the Route 50 Cardinal, was scheduled to depart from Indianapolis, Indiana, at 12:15 a.m. on Friday, June 23rd, 2023. It left on time. And it arrived at my stop, Washington DC’s Union Station, at 6:40 p.m., 4 minutes ahead of its scheduled 6:44 p.m. arrival. You can learn more about Amtrak on its website.

I live in Lexington, Kentucky, which has no passenger train service. I took a Greyhound bus from Lexington to Indianapolis, devoted a day to sightseeing in Indianapolis, then caught the train.
Boarding the Train
After boarding for the train was announced at Indianapolis‘s Union Station, I joined a crowd of others climbing up the stairs from the waiting area to the train platform. In the waiting area, I'd seen one elevator with two "out of order" signs on it. All persons seemed to take the wide stairs, which had railings on both sides and a platform midway up them. An employee asked persons who needed assistance to wait till last.
At the top of the stairs, I followed those ahead of me to the right. I saw a line of persons preparing to board a train car. An Amtrak employee there instructed Coach passengers to keep walking, and said, “Sleeper passengers talk to me.”
Sleeper passengers are those who’ve paid extra (much extra) to get a private room with furnishings that include a bed. The other type of passengers are Coach passengers, which just have a seat.
I was a Coach passenger, so I went on down to another line at another car. When I got to the front of the line, an Amtrak attendant scanned my ticket. Then he told me I was assigned to seat #11, a window seat, gave me a piece of paper with the number 11 on it, and said to go up the stairs and to my right. I asked him, “Are the numbers on the seats?” He politely replied, “No, above the seats.” I thanked him for the information.
Then I walked up the train car stairs with my two carry-on bags. Amtrak allows substantially more baggage than Greyhound buses or planes. Amtrak allows two checked items of up to 50 pounds each, two carry-on items of up to 50 pounds each, and two personal items of up to 25 pounds each. That's a total of up to 250 pounds of luggage.
I didn’t check any baggage, and only had two carry-on items, an American Tourister carry-on bag and a JanSport backpack.
When I reached my seat, which was on the right side of the train, I saw the number above it, 11. I met my seatmate, Al, a friendly guy with significant prior Amtrak riding experience. Al had the seat beside me, seat #12, an aisle seat. He was putting his bags into the overhead luggage rack.
I think there were a total of 60 seats in the Coach car I rode on, but I’m not sure.
After folks were boarded, and probably after the train had left the station, though I don't remember, an attendant came down, asked our destinations, and wrote them on a paper he attached above our seats near the seat numbers. My seatmate Al was going to Baltimore, which was beyond my Washington, DC, stop.
Our train was sold out. At one stop, the attendant told us that many persons would be getting off, but the train was sold out and others would be getting on to fill those empty seats. We should not change seats without permission. He said passengers could change seats after the Washington, DC, stop if desired.
Furnishings on the Train
A restroom was located in the rear right of my car. In the rear left of the car was a tank of water with a push-button spigot and paper cone-shaped cups to get drinking water.
The train’s restroom was clean and wellstocked both times I used it. The drinking water tasted okay, and seemed to be about room temperature.
On the left side of the rear of the car was a baggage area for carry-on baggage, near the water tank. It would have held large luggage. But I didn’t use it. I put one of my two carry-on bags in the overhead compartment above my seat. I put the other one, my backpack, in the floor in front of me, though it would have fit overhead too.
My seat legroom was generous. I had room for my backpack as well as my feet.
Amtrak seats are well padded. They include a foot rest that can be lowered to use if desired. They also include a padded calf rest that can be adjusted to support one’s lower leg much like a home recliner chair. The padded seat back reclined nicely and supported the back and head well. It didn’t recline quite as much as a home recliner, but it was comfortable. However, I’d have liked to have had a neck pillow. I think Amtrak did sell them on board as part of a “comfort package” that I think also included ear plugs and a blanket, but I didn’t buy one. 
Al, my experienced seatmate, patiently answered my questions, and explained how to adjust the seat.
A fold-down table was at my seat. Also, there was an electric outlet at my seat. And the train offered free wi-fi, which worked well in the Indiana portion of the trip. But after reaching Cincinnati and for much of the rest of the way it seldom worked. Fortunately, I had plenty of data on my phone when I chose to access it for news, weather, etc.
On this train, the Coach cars were directly behind the engine. They were followed by a lounge/dining car. Coach passengers can sit in the front part of the lounge/dining car. The middle part is the café where food can be ordered a la carte. The back part of this car is reserved for Sleeper passengers. A sign at its entrance states that Coach passengers can’t go beyond its doorway into it.
I took many snacks with me, as well as water. But I tried out the café, ordering two blue corn tamales and an orange juice. The tamales at $5 each were tasty, but small. The $3 orange juice was a bottle of MinuteMaid aseptic juice, and had a bit of burnt oranges taste, as aseptic orange juice often does.
Sleeper passengers get free complete meals included in their ticket price, and can make purchases at the café if desired. Coach passengers may be able to order meals in the café similar to those of Sleeper passengers, but I’m not sure. At any rate the prices are relatively expensive.
If I was traveling long distance and eating all my food from the café, I think I could spend over $100 a day just on food and drinks. That may be a bit of hyperbole, but maybe not.
Stops and the Train Whistle
During my scheduled trip of over 18 hours, the train made many scheduled stops. But according to the schedule, none of the stops was to be more than 10 minutes. Since we arrived a few minutes ahead of schedule, I’m guessing they adhered pretty well to that timetable.
Most of the train stations seemed to be on the left side of the train. However, one on the right side was the one in Alderson, West Virginia, shown in two pictures below. According to Amtrak's website, Alderson is just a "platform with shelter" and no restrooms, indicating Amtrak passengers cannnot actually go in the station itself.



Amtrak may have added cars and/or taken away cars at one or more of the stops. But if so they did it quickly.
For at least part of the journey, my car was directly behind the engine. It seemed that I could hear the train whistle blow every minute or two for a crossing of some type. I was in the rear of the car, so it wasn’t as loud as it probably was in the front of the car.
When I walked back to the lounge/dining car, the sound of the whistle was much quieter. It was probably relatively quiet in the Sleeper cars at the rear of the train.
Scenery and the Trip
I’d seen many pictures online of views from Amtrak trains. Those pictures typically came from western train routes. I can guess a reason why. Much of the scenery on my route was of deciduous forests, except for when we were in towns or near roads. During the winter you can probably see more.
During a significant portion of the trip, from Charleston, West Virginia, to somewhere in Virginia, an onboard guide read from a script and spoke through the train speaker system telling about numerous significant points. More than 80% of the things she described were on the left side of the train, and I couldn’t see most of them. Still, I enjoyed the narration.
Below is a photo of some trees and a river. White water rafters were in parts of the river, especially earlier in the journey, west of where this photo was taken, when the river was on the left side of the train.

There were three or four times during the Virginia portion of the trip when my train car leaned toward the left. On one occasion especially, I thought it might turn over, which was a bit disconcerting. The train was moving very slowly at this time, presumably due to bad tracks.
My seatmate who had much experience riding Amtrak, said it may have almost turned over there. He said he’d never had that happen before.
Not far after that location I saw a large piece of construction equipment near the track. Maybe repairs are being made.  
Al told me that most of his Amtrak experience was in the western United States where the tracks were in better shape. He stated that the eastern tracks were much older and had a lot of heavy freight traffic that damaged them. His explanation makes sense. He also said that the western United States is less congested, and the train can go several miles without blowing its whistle.
Exiting
After arriving at Washington's Union Station, I debarked, then walked along a sidewalk platform that was perhaps 12 feet wide, with others who had exited the train. Yellow lines perhaps two feet from the right and left edges allowed spacing before train tracks on either side. This left perhaps an eight-foot sidewalk platform to walk on. After walking perhaps a few train-car lengths, we debarked passengers came to an escalator up. After riding the escalator up, I got off it and I followed signage to Union Station's shops, etc.   
Closing Thoughts
Amtrak trains offer much more leg room and comfort than buses or planes, based on my limited experience. The opportunity to get up and walk to the lounge/dining car and other Coach cars is nice too.
I’d recommend a train over the bus or a plane for trips of a few hundred miles. For persons with the time, I think even a lengthy rail trip of several hundred miles that includes one overnight period is preferable to flying, due to cost savings and extra comfort, and preferable to  bus travel due to increased comfort.
However, persons traveling Coach who desire to sleep might want to wear earplugs, or maybe ear plugs + over the ear, noise reduction ear muffs. Though I had both with me, I slept some without wearing them. But many, if not most, other passengers might not sleep that easily
I did miss the meal stops on Greyhound buses though. If I were traveling a long way, I’d prefer a stop for 20-30 minutes at least once a day to buy a meal from a restaurant or snacks from a convenience store instead of paying Amtrak prices for its limited café menu, or buying an expensive meal.
My Coach ticket from Indianapolis to Washington, DC, only cost $73 purchased well in advance, which is probably comparable to the cheapest Greyhound ticket and much cheaper than flying.
My trip went well. I’d love it if Amtrak covered as many locations as Greyhound and offered much more frequent service.
NOTE:
This article was last revised on July 5th, 2023.

Sunday, February 26, 2023

I Thought Medicare Was Free and Comprehensive: I Learned Differently

As a child growing up decades ago, I used to think that Medicare offered free medical coverage for senior citizens that covered virtually all their medical expenses.

I thought that after paying into the system during one's working years, it cost nothing for comprehensive coverage during retirement years.

I learned differently in recent years.

My new insights probably began a few decades ago from reading newspaper articles about Medicare and then from talking with my dad who was researching Medicare plans a few decades ago.

Over the last several months, I learned much more as I researched Medicare plans for myself.

Medicare.gov: Excellent Resource for Information

First of all, I want to state that the official government website Medicare.gov provides much guidance about the parts of Medicare, their coverage, when to sign up, how to sign up, costs, etc.

Please refer to it for authoritative guidance, not me. To learn basics, go to the Medicare.gov "Get started with Medicare" webpage.

That website basically discusses all that I mention below and much, much more.

Medicare also provides a booklet to Medicare recipients that covers a great deal of information about Medicare in over 130 pages. Below is a photo of my copy.


I urge you to consult the government's website and publications for accurate, official information about  Medicare. But, below I briefly summarize some of what I learned.

Overview

I'm a firm believer in God. For many years when I had no human medical insurance, God blessed me with health. I'm confident even if I hadn't signed up for Medicare, God could bless me with health, making insurance unneeded.

And I support quality preventive care such as proper exercise, diet, rest, etc. But I know none of us engages in perfect preventive care.

I believe human health insurance has a purpose. And as we get older, we may need it more. God can work through human medical professionals.

So several months ago, I began researching Medicare in preparation for enrolling in it.

Some of What I've Learned

Medicare consists of five parts:

  • Part A,
  • Part B,
  • Part D,
  • Medigap or Medicare Supplement Insurance of various types,
  • Part C or Medicare Advantage--also called Medicare Disadvantage by some, as discussed on the December 31, 2022, Ralph Nader radio show episode. The website MedicalWire lists what it considers some disadvantages of Medicare Advantage, while noting that it can be "good or bad. It all depends on your personal situation." As I neared age 65, private companies mailed me many solicitations about Part C.   
I elaborate on the five Medicare parts in the next subtopic of this article. But the paragraphs below offer a brief summary in oversimplified terms.

Part A is hospital insurance that has a deductible. It is free for most persons age 65 and older. 

Part B is outpatient insurance that has a deductible, copayments, and a monthly charge.

Part D is private insurance that covers much of the cost of prescription medicines. It has copays, a monthly charge, and maybe a deductible, depending on which Plan D a person selects.

Medigap (Medicare Supplement Insurance) is private insurance that covers deductibles and copays in Parts A and B and has a monthly charge. Several different Medigap plans exist.

Part C (Medicare Advantage) is private insurance that replaces Parts A, B, and usually includes D. It is less standardized than the other four plans. Numerous options exist. Some Part C plans cost nothing for the insurance itself, even paying for the Part B monthly charge, and offer limited dental, hearing, and vision coverage not in other Medicare plans. But out-of-pocket costs for persons who use Plan C for medical care may be much higher than with Plans A, B, D, and Medigap. Part C may require preauthorization, out of network charges may apply, and coverage may be denied that would be approved for Parts A, B, and Medigap.

Purchasing Parts A, B, D, and Medigap all four would likely yield excellent medical care coverage, if you purchase the best D and Medigap plans available. But it might cost a total of at least a few hundred dollars per month for the insurance premiums.

Selecting Plan C alone may give you low or even $0 monthly insurance charges. But out-of-pocket costs may be huge if you are sick and pay deductibles, copayments, out-of-network costs, costs for denied claims, etc.  

More Details About What I Learned 

Medicare A, B, D, and Medigap typically do not cover most dental care, hearing tests and hearing aids, or routine vision exams and glasses. Medicare also typically does not cover long-term nursing home care. If desired, separate dental, hearing, vision, and long-term care policies would need to be purchased from private companies.

Medicare Advantage (Part C) plans limit one to the particular private insurer's network, have other limitations, and are often more likely to deny medical coverage for various things. But Advantage plans may provide some dental, hearing, and vision coverage that regular Medicare doesn't. Like the other plans, they do not provide long-term care coverage.      

Persons on Medicaid may get all Medicare coverage (and more) free.  But only Part A and some Part C plans are free for typical persons. And high income persons must pay higher costs for Part B and Part D coverages.

Below I discuss the five parts of Medicare in more detail.

(1) Medicare Part A is free for most retirees due to deductions from paychecks during employment. It pays all covered hospital expenses for the first 60 days of the first hospitalization during the coverage period after a patient meets a $1,600 deductible. It also offers some coverage for extended stays and other stays. This is discussed in detail on the Medicare website. The Medicare.gov webpage "What Part A covers" discusses Part A coverage in detail.

(2) Medicare Part B costs $164.90 per month for most persons covered by it for 2023. After you meet a $226 deductible, it covers most outpatient medical expenses on a basis of 80% coverage and 20% copay. In other words, recipients pay 20% of most covered costs. The Medicare.gov webpage "What Part B covers" discusses Part B coverage in detail. 

(3) Medicare Part D covers many prescription drugs. It is sold by private companies, not the government, though the government regulates its coverage. The various Plan D insurance policies cover different drugs. Furthermore, the plans divide the drugs into tiers, and each insurance plan has its own guidelines for which drugs go into which tiers. A Medicare.gov webpage provides details.

(4) Medigap or Medicare Supplement Insurance is sold by private companies. But what the plans cover is set by the government. Persons who purchase Medicare Parts A and B may purchase Medigap to cover many of the expenses not covered by Medicare A and B.

Several different Medigap plans exist. The various plans are designated by letters of the alphabet (A, B, C, D, F, G, K, L, M, N, and high deductible options for some of those). Medigap plans C and F aren't available for those who turned 65 in 2020 or later. Those two plans paid the Part B deductible which is currently $226. The government no longer allows coverage of that deductible.

The government standardizes what each supplement plan covers. For example, Plan G appears to be the most comprehensive one available for new enrollees now turning 65. It covers the $1,600 deductible for Medicare Part A, the 20% copay for Medicare Part B (but not the $226 Part B deductible), and some other expenses detailed on the Medicare website.

Even if you enroll in a Medigap plan during your initial eligibility period, you may be denied Medigap coverage for pre-existing conditions for up to six months unless you have creditable coverage, according to the websites MedicareInteractiveMedicareGuide, and other sources including page 14 of the 52 page official government guide "2022 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare." Your Medicare A and B would cover pre-existing conditions, subject to their usual deductions and copays.

A Medicare.gov webpage discusses what Medicare Supplement Insurance (Medigap) is.

Another Medicare.gov webpage provides more details about the various Medigap plans.

(5) Plan C or Medicare Advantage is a private insurance program. Persons enrolled in Medicare A and B may then choose to enroll in a Medicare Advantage plan, which typically encompasses A, B, some type of D, and maybe some dental, hearing, and/or vision coverage. But Medicare Advantage policies have a network of approved caregivers and may deny coverage that would be available under A and B of regular Medicare.

Plan C's monthly insurance costs may be low or $0. But if you need medical care, your out-of-pocket costs may be high. 

Medicare Advantage advantages and disadvantages are discussed in a Consumer Reports article updated November 3, 2022. The Medicare.gov webpage "Medicare Advantage Plans" discusses Medicare Advantage plans in detail.   

Signing Up for Medicare

Some persons are automatically signed up for Medicare Parts A and B at a certain time, such as those on disability. Also, those already drawing Social Security benefits for a certain number of months before turning age 65 are automatically enrolled when they become eligible.

These Social Security recipients who don't want to pay for Part B can opt out of Part B. But anyone who doesn't sign up for Part B when initially eligible may pay a higher rate as a penalty if they sign up later.

Persons not automatically enrolled, such as those not already drawing Social Security benefits for a certain number of months prior to age 65, need to sign up if they want to enroll in Medicare.

Persons first sign up for Medicare A (and if desired Part B). Then after A and B, one can also choose to enroll in Part D, and also a Medigap policy.

Persons who delay signing up for D but choose to later may pay higher rates.

Persons delaying signing up for Medigap but choosing to later may have their application denied or may pay higher rates if they can enroll. Also, your application for Medigap may be denied if you desire to switch from one Medigap plan to another after your initial six-month open enrollment period, as noted on a Medicare.gov webpage. Some plans may offer a low rate the first year, but raise it significantly as you get older, while at least one, affiliated with AARP, uses similar prices for various ages.

A Medicare.gov webpage notes that Medicare Supplement (Medigap) policies can be priced in three ways, (1) attained-age-rated, (2) issue-age-rated, or (3) community-rated.

For example, the AARP Medigap G plan from UnitedHealthcare is community-rated and may be more expensive for the first year at age 65 for a new enrollee than some other age-rated Medigap G plans, but those other age-rated plans may be significantly more expensive in future years.    

As an alternative to Medigap and D, after signing up for A and B, one can sign up for a Medicare Advantage plan. The Medicare Advantage plan would replace the standard Medicare A and B, and the Medicare Advantage typically includes a Plan D. 

Persons choosing to sign up for Medicare Advantage do not sign up for a Medicare Supplement Insurance plan. 

The Medicare.gov website discusses details about how to sign up for the various Medicare parts. It also lists all the Medicare Part D, Medicare Supplement Insurance, and Medicare Advantage plans available to persons by zip code.

Changing Medicare Plans

Medicare recipients who desire to change the type of Medicare coverage they have, can do so during certain periods each year. Details are on the Medicare website.

But it's important to note that if you decide after over a year on a Medicare Advantage (Part C) plan to change from Part C with its limitations to original Parts A and B to get better coverage, you may not be eligible to add Medigap coverage. Medigap applications outside of the initial enrollment period may be denied.

Often persons who file bankruptcy due to medical bills or end up on Medicaid are persons with medical insurance, but who can't pay deductibles, copays, and other costs that are excluded from coverage under plans that offer limited coverage.

If you can afford it, it might be better to purchase a quality Medigap policy, such as Plan G, soon after you initially enroll in Medicare A and B, and add Part D too.

But for those on a tight budget, enrolling in Plan A by itself is usually free. And signing up for A and B, then switching to a low-cost Plan C is another one of the various possible combinations to lower insurance costs. Medicaid is another option for the poor.

Value

Medicare may not be comprehensive free medical insurance for recipients. But it is an excellent value. The cost of Medicare insurance is much lower than buying comparable private insurance.

Furthermore, if you sign up for the most comprehensive Medicare plans, your coverage is significantly better than most private insurance.

Medicare's Financial Situation

Numerous news reports have noted that Medicare (and Social Security) risks running out of money to pay full benefits in the future unless changes are made. Increases in revenue paid into the programs and/or cuts in benefits are likely in the future.

"A Summary of the 2022 Annual Reports" on the official Social Security website states "Social Security and Medicare both face long-term financing shortfalls." The article goes on to state that current data indicates that Medicare can only pay for Part A "until 2028." After that revenue will only pay for part of the expenses of Medicare Part A.

My guess is that Congress will take action in the near future to make necessary modifications to ensure the financial stability of Medicare. Congress may increase the Medicare eligibility age for young persons or increase the amount paid into the system. But it remains to be seen.

The best solution might be for we individuals to take better care of our health, thus reducing the need for professional medical care. I'm not a medical professional and can't give any medical advice. But in a 2019 Google Blogger article "True Health Care Reform: Better Preventive Care," I offered some suggestions for taking better care of our health.

However, my suggestions in that article are not perfect. And even if they were, I know that writing and reading such guidance is easier than following it. 

My Choice, Recommendation, and Closing Thoughts

Each person makes their own choice on what to sign up for. Persons who have quality coverage from an employer may decide to delay signing up.

I signed up for Part A and Part B prior to turning 65, so their coverage would take effect at the beginning of the month I turned 65. Then I signed up for a Part D plan. Then I signed up for Medicare Supplement Plan G.

Plan A is free, but Plans B, D, and G, cost me a total of approximately $400 monthly for the particular choices I selected in my particular zip code. This cost is substantially lower than private insurance would cost.

God has blessed me with two part-time jobs I love that seem to benefit others and so far enable me to keep my budget balanced. Living in a studio efficiency apartment, not owning a car, and preparing most of my meals in my apartment are blessings that help lower the cost of living.

I recommend that persons who are within a year or less of turning 65 begin considering Medicare and the choices to be made. The federal government offers much guidance on its Medicare website.

Finally, while I am grateful for Medicare, grateful for two part-time jobs that I love, grateful for my health and all my innumerable blessings, and seek to live a healthy lifestyle, I know that the highest righteous power, God, is ultimately in control and deserves total credit for my health, my life, and all benefits in my life. Being healthy is better than having quality human medical insurance coverage.

Praises to God for all the innumerable blessings God will provide, provides, and has provided, including God's love, guidance, and patience in my life and in the lives of others. Let's all seek to discern and follow God's perfect leading, whatever that may be.

Disclaimer:

I am not a medical professional. I am not a medical insurance sales representative. And I am not a government employee. I am not qualified to provide professional Medicare or medical advice.

As far as I know, the information in this article was basically accurate when originally posted. However, I may have inadvertently made errors in posting the information.

Please consult the official Medicare.gov website for accurate, up-to-date, detailed official guidance.

I don't deserve credit for the facts in this article. They all basically came from the official government website, Medicare.gov.

This article provides my personal opinions. I am not paid by Medicare, any insurance company, or any insurance sales representative for expressing my opinion.

The husband of one of my sisters is currently an insurance sales representative whose work includes selling medical insurance and whose business includes dealing with Medicare, but I did not consult him at all in writing this piece. The views in this article are mine alone.  

NOTE:

This article was last revised on April 10, 2023.