Anyway, I opened it today. Mediare apparently isn't just Medicare, there are lots of plans that "manage" the Medicare as with private insurance. The services offered are the same, but my doctors will actually be working with a private group rather than the state, and I think some doctors will only work with some of those plans or others. I ended up choosing Fidelis because it has the best coverage in my neighborhood, and is it turns out Fidelis is Catholic. That means they don't pay for pretty much any kind of family planning the church considers verboten - hormonal BC, condoms (Medicare covers condoms?), and IUDs, vasectomies and tubals, and abortions. Interestingly, NY state does require Medicare to cover abortions if a doctor agrees they're necessary. No elaboration of what that means, but I'd imagine it's if the pregnancy carries a health risk to the mother, physically and maybe even psychologically. Maybe if the fetus isn't viable, too; I'm honestly not sure.
On the one hand, I'm not thrilled about religious groups, or groups of any kind, getting an exception based on their ideology. That's just a basic matter of principle for me: it feels like forcing their ideology on people who don't share it. On the other hand, this is different or feels different at least from a company refusing to cover contraception - they're not shirking some obligation, and it's not the state who's having to pay for something my insurance actually should be paying for. (The insurance isn't compensation for anything I've done, and in any case no one's getting denied anything that I can see.) Medicare provides a fairly easy work-around: the BC is still covered, the doctor just has to bill Medicare directly rather than going through Fidelis. I checked - if I needed BC, I could actually go to the same doctor, she'd just have to file the paperwork differently. And if a doctor only took Fidelis, I'm not sure that's more of an obstacle than if a doctor was out of network for any other reason. So... I don't know. It makes me mildly uncomfortable, but only mildly. Fidelis seems low-drama about the whole thing, they gave very clear instructions on how to access the services and on poking around online a bit I didn't see any fuss over them having to "facilitate" something Catholic teaching forbade. And the procedures are still available to people on the Fidelis plan, it's just a matter of billing Medicare directly rather than going through the Fidelis plan. Still, it strikes me as interesting.
More interesting perhaps is how I feel knowing my tax $$$ has been covering abortions all these years. I'm actually a bit surprised that I didn't bat an eyelash at that - I would have expected myself to be at least mildly uncomfortable. I think women should definitely have the right to make this choice and I don't want to make abortion illegal, but in most cases (not all, but most or at least many) I think it's an immoral choice, one I think women have a moral duty to avoid or minimize where they can. So I was more than a bit surprised that that bit was just mildly interesting to me. I really do seem to have internalized the idea that there's a difference between me using the money to do something and my taxes being used for something I wouldn't do myself. Part of being in a society and respecting your fellow citizens' freedom is letting that choice actually be up to them.
Anyway, it's all academic here - I'm not sexually active, so it's highly unlikely I'd ever need birth control (unless the pill was for some other medical purpose like correcting hormones, and even the RCC allows that). but it's kind of an interesting wrinkle I didn't anticipate bumping into. This seems well-handled, though, balancing Fidelis's interestws to have the area Catholics help get poor people medical care while at the same time respecting their own beliefs, and from what I can see, there's just not very much posturing at all going on between the two sides. It's almost refreshing, actually.