Home Health Insurance The Medicare Episode – KFF Well being Information

The Medicare Episode – KFF Well being Information

The Medicare Episode – KFF Well being Information


Medicare might sound like an escape from the costly world of U.S. medical insurance, nevertheless it’s extra sophisticated, and costly, than many understand. And selections seniors make after they join the federal medical insurance program can have big penalties down the highway. 

Host Dan Weissmann speaks with Sarah Jane Tribble, KFF Well being Information’ chief rural well being correspondent, about one of many greatest decisions seniors should make: whether or not to enroll in conventional Medicare or the privatized model, Medicare Benefit. 

Then, Weissmann shares sensible recommendations on how soon-to-be seniors can keep away from penalties and choose the plan that’s proper for them.

Dan Weissmann


Host and producer of “An Arm and a Leg.” Beforehand, Dan was a workers reporter for Market and Chicago’s WBEZ. His work additionally seems on All Issues Thought-about, Market, the BBC, 99 P.c Invisible, and Reveal, from the Middle for Investigative Reporting.


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Transcript: The Medicare Episode

Observe: “An Arm and a Leg” makes use of speech-recognition software program to generate transcripts, which can comprise errors. Please use the transcript as a software however verify the corresponding audio earlier than quoting the podcast.

Dan: Hey there–

So, one factor we now have by no means talked about on this present? Medicare. , that free-health-care factor chances are you’ll count on to get whenever you flip 65.

It’s been on a listing of issues the place I’ve been like, “that’s TOO massive, and TOO sophisticated. I can’t get my arms round that simply now.” 

Particularly as a result of: There’s this factor known as Medicare Benefit — a type of privatized model, run by insurance coverage corporations? Appears controversial, and REALLY sophisticated. 

I’ve been like, Perhaps sometime.

And that sometime? That’s in the present day. Or not less than, we begin in the present day. Primarily as a result of a colleague of mine simply did a BUNCH of labor that we get to piggyback off of.

Sarah Jane Tribble: my identify is Sarah Jane Tribble and I’m Chief Rural Well being Correspondent with KFF Well being Information.

Dan: And as Sarah Jane reported on Medicare, she was stunned by how a lot she didn’t know. And the way a lot folks didn’t know both. 

Sarah Jane Tribble: At Thanksgiving, once I was engaged on a few of these tales, I’ve buddies who’re nearing retirement. They’re not likely shut , however they’re shut sufficient to care and so they’re avid NPR listeners. And so they have been like, wait, so what’s the distinction between Medicare Benefit and Medicare? And I used to be like, they need to know. 

Dan: Who’s going to inform them? 

Sarah Jane Tribble: Proper?

Dan: That’s us, I suppose. 

Sarah Jane Tribble: This present will assist inform them.

Dan-in-tape: I hope so. I hope so. 

Dan: As a result of this traditional-Medicare vs Medicare Benefit — it’s a excessive stakes choice, it occurs whenever you first enroll.

And right here’s the massive factor that Sarah Jane discovered: in the event you join Medicare Benefit, at that time, whenever you first get on Medicare, you’re just about caught with it. And a few folks find yourself with purchaser’s regret. Massive time.

And truly, past that alternative — between Medicare Benefit and what’s known as “conventional Medicare” –, there’s actually a complete alphabet soup of different decisions you’re gonna have to make. Every with a price ticket, and perhaps some massive trade-offs. 

And there’s been loads of questionable data that comes at folks. TV reveals that older of us watch have been stuffed with adverts with Folks Who Had been Actual Well-known within the Seventies.

J.J. Walker: Hello, I’m Jimmy JJ Walker. 

Joe Namath: Hello, I’m Joe Namath. 

William Shatner: William Shatner right here with an essential message. I’ve been on Medicare for longer than I’ll admit, and it positive has modified. 

Dan: A few of these adverts make claims that sound too good to be true

J.J. Walker: And get this, I’m entitled to an additional 100 a month. That’s 1, 200 a yr added to my social safety verify. And I used to be like, dyn-o-mite!

Dan: Final yr, the feds finalized new guidelines to try to rein in sketchy claims from some adverts like these. 

So understanding what’s occurring, it’s an enormous deal. We’ll run down what I’ve discovered to date, together with some extraordinarily skilled steerage. 

Our skilled, by the way in which, set me straight on a bunch of issues, together with, sadly, this: Medicare isn’t truly the free-health-care thingy a few of us hope for.

Sarah Murdoch: Sadly, I feel lots of people suppose, Oh, Medicare goes to be free , it sadly shouldn’t be.

Dan: The query is how a lot it’s going to value you– in {dollars}, and perhaps in your decisions managing your personal well being care. And shock! It’s tremendous sophisticated.

So by the point we’re finished, you’re gonna perceive the distinction between Medicare Benefit and conventional Medicare — and the right way to begin sorting via the alphabet soup.We’ll additionally go away you with some stable assets to determine what your best option could be when the time comes, both for you or any person you care about.

Let’s do it.

That is “An Arm and a Leg,” a present about why well being care prices so freaking a lot, and what we will perhaps do about it. I’m Dan Weissmann. I’m a reporter. I like a problem — so the job we’ve chosen right here is to take one of the enraging, terrifying, miserable elements of American life, and convey you one thing entertaining, empowering, and helpful.

OK, in relation to Medicare, the most important alternative of us need to make is between conventional Medicare — run straight by the federal government — and Medicare Benefit plans, that are run by personal insurance coverage corporations. And once more, that’s plans, as a result of a bunch of various insurance coverage corporations supply completely different Medicare Benefit plans. 

And final yr, Sarah Jane Tribble began listening to from CEOs of rural hospitals.

They have been telling her: Medicare Benefit plans are killing us. We’re spending a ton of money and time preventing with these insurance coverage corporations to receives a commission. And typically we don’t receives a commission.

Sarah Jane Tribble: After which I used to be additionally listening to about sufferers displaying up on the hospital and these native hospitals saying, “oh, no, we truly don’t take your plan.” And so that you’ve obtained these small city, you understand, of us who’ve just one hospital and an extended, you understand, giant radius. And they’d present up and the hospital could be like, “Ah, you’re going to need to pay out of pocket as a result of we don’t take this Medicare Benefit plan.” And the affected person, in fact, could be like, “however I’m on Medicare, you’re speculated to maintain me.”

Dan: Yeah. Isn’t that take care of Medicare? All people accepts it. You get on Medicare, you’re taken care of?

Sarah Jane Tribble: I started questioning, how a lot does signing up for a Medicare Benefit plan truly have an effect on the care you get?

Dan: And the reply looks like: Perhaps loads. 

Slightly Google looking turns up loads of headlines about claims getting denied, and about hospitals dropping Medicare Benefit plans. 

And it additionally turns up a report from the Inspector Basic’s workplace on the federal Division of Well being and Human Companies. 

And in the event you’ve obtained common insurance coverage, chances are you’ll be accustomed to what’s known as “prior authorization.” That’s when your supplier must get the insurance coverage firm’s OK, their authorization, earlier than going forward with no matter they suppose you want … a take a look at, a process, a prescription. 

And typically the insurer points a denial. They are saying no.

The Inspector Basic’s report checked out a random pattern of denials by Medicare Benefit plans. They discovered one out of each eight denials was for care conventional Medicare completely covers. 

Which, you understand, as you grow old, in the event you obtained sick, you may have eight of those requests in a month. 

Sarah Jane began speaking with sufferers.

Sarah Jane Tribble: I known as one gentleman in Washington state, and he needed out of his Medicare Benefit plan and he couldn’t get out.

Dan: That gentleman is Rick Timmins. 

Rick Timmins: I’m a retired veterinarian. I’m dwelling on Whidbey Island in Washington, which is simply north and west of Seattle.

Dan: Ooo, wow! So, is your life only a succession of paddling journeys …

Rick Timmins: Ha ha ha ha ha ha. 

Dan: and swims within the sound?

Rick Timmins: Sure, type of. Though the water is slightly bit too chilly for me to swim in. So, it’s kayaks once we get out into the water.

Dan: Rick signed up for Medicare Benefit in 2016 after attending an informational seminar run by an insurance coverage agent. 

Rick Timmins: … good man, and he mentioned, you understand, the perfect factor to do is to get a Medicare Benefit plan as a result of they cowl the whole lot, and it’s, it’s far inexpensive than conventional Medicare,

Dan: OK, why would that man say Medicare Benefit is way inexpensive than conventional Medicare? I imply, for one, loads of us suppose Medicare’s gonna be free. 

And even when it’s not, why ought to … I imply, how may … one type of Medicare be costlier than one other? 

We’re gonna have a lot of particulars on this later, however right here let’s simply get into the distinction between Medicare Benefit and conventional Medicare. Conventional Medicare is run by the federal government. Authorities pays all of the payments. 

BUT conventional medicare solely pays 80 % of the whole lot and also you’re on the hook for the opposite 20 %. There’s no out-of-pocket restrict. Let’s carry again Sarah Jane Tribble to briefly say what which means: 

Sarah Jane Tribble: You may pay out the wazoo. It may bankrupt you. 

Dan: Out the wazoo. As a result of you understand: Medical payments, hospital payments … they’ll get into the tens of 1000’s, lots of of 1000’s of {dollars}. Twenty % of that’s paying out the wazoo. 

To keep away from that danger, in the event you’re on conventional Medicare you mainly want one other insurance coverage coverage — a complement, usually known as Medigap — prefer it covers the gaps that conventional Medicare leaves. 

Some folks get Medigap from their outdated employers. However most individuals need to pay for it. It may well get costly. 

Medicare Benefit plans, plans run by personal insurance coverage corporations, DO have an out of pocket restrict. You don’t have to purchase a complement. That’s a bonus. 

Additionally, there are issues conventional Medicare doesn’t pay for — like dental care, and glasses, and listening to aids. Medicare Benefit plans usually DO cowl these issues. 

And as Rick remembers, the insurance coverage agent pushed Medicare Benefit kinda laborious.

Rick Timmins: Mainly what he mentioned was, yeah, if you wish to join conventional Medicare, I can assist you for that, however if you need Medicare Benefit, which is a significantly better program…

Dan: Then signal proper right here. So Rick did. Quick ahead 5 years. Rick’s spouse notices slightly bump on his ear. 

Rick Timmins: She mentioned, you need to get that checked out. I’ve a household historical past of melanoma. My two sisters have had melanoma.

Dan: Rick says he noticed his main care doc, then began making an attempt to get his insurance coverage firm’s promise that seeing a specialist could be coated. He says he known as and known as, over greater than six months.

Rick Timmins: It was not a enjoyable time. I imply, I didn’t know what it was, however I knew that it was rising and it was sore and you understand, I used to be frightened. It’s like you may’t take into consideration anything whenever you’re questioning about what’s occurring with this little lump.

Dan: Rick says when he did get seen, the factor was the scale of a dime. They discovered it was malignant, reduce his earlobe off, and scanned his lymph nodes. They have been clear, however he spent a yr on immunotherapy. Now he says he’s getting scans each six months.

Sarah Jane Tribble requested Rick’s insurance coverage firm about all this. They mentioned they wouldn’t touch upon his case.

In the meantime, Rick says he’s had sufficient of Medicare Benefit. On conventional Medicare, you don’t want anyone’s OK to go see a specialist. You simply go. 

However in fact to change to conventional Medicare, Rick would want a complement, a Medigap coverage.

Rick Timmins: In any other case, uh, you’re simply forking out 1000’s of {dollars} in case you have any points.

Dan: Since you’re on the hook for 20 % of the whole lot. No out of pocket restrict. Paying out the wazoo.

However Rick doesn’t suppose he can get a medigap coverage. As a result of in most states — together with Washington, the place Rick lives — insurance coverage corporations don’t need to challenge you a Medigap coverage in case you have pre-existing circumstances. 

Not except you join it whenever you FIRST enroll in Medicare. 

Rick Timmins: The insurance coverage corporations can inform me, no, we don’t need to insure you. You’ve had too many points. Look, you had a knee changed. You had most cancers. 

Dan: That is what made Rick’s story, and the entire Medicare scenario, so putting to Sarah Jane Tribble.

Sarah Jane Tribble: It’s type of surprising, truly, proper? The Reasonably priced Care Act passes and makes it so that everyone with pre-existing circumstances can get insurance coverage it doesn’t matter what, nevertheless it leaves out the individuals who may want that probably the most, who’re 65 and older. 

Dan: 4 states have legal guidelines that do require Medigap insurers to take all people. However solely 4. 

Sarah Jane Tribble: For those who’re Rick in Washington state, you may get rejected.

Dan: I talked to another person who would really like do-overs on signing up for Medicare Benefit. Within the Seventies, in his 20s, Robert Wolpa was knowledgeable musician, a guitar participant. 

Robert Wolpa: Performed in bands up and down the west coast. Went to Canada with an Elvis act. It was actually loads of enjoyable. 

Dan: And he labored in name facilities for many years. When he turned 65, he says he obtained inundated with adverts and calls and flyers.

Robert Wolpa: I obtained one of many mailers says have a free dinner on us. And we’ll educate you all about Medicare, the ins and outs of Medicare.

Dan: He went, and obtained what he thinks of looking back as a hard-sell pitch for Medicare Benefit, which he purchased. And, over time, he’s gotten disillusioned. 

He says, you understand, it’s one factor to need to name to get a pre-authorization or a referral. “Is that this physician coated? No. Oh okay. Which physician is roofed?” It’s loads of calls. After which there’s the issue of getting via the calls.

Robert Wolpa: It obtained tougher and tougher and extra irritating, speaking to a few of these individuals who didn’t know what they have been doing. I imply and I’ve been a name middle man too for many of my life however these poor folks. I imply they’re so undertrained and underpaid.

Dan: At the least, that’s the impression Robert will get, as a man who spent years working in name facilities.

Robert has priced out a Medigap plan. As a result of he’s obtained pre-existing circumstances — HIV, a pacemaker — it could be costly: 4 hundred seventy 9 {dollars}. Which is nearly a 3rd of what he will get from social safety. 

Robert Wolpa: And I mentioned, okay. Subsequent choice. 

Dan: I recommend perhaps his work background offers him a bonus in leaping via hoops, like making all these calls: each realizing the right way to navigate, and having empathy that might assist him preserve his blood stress from spiking too laborious. He says, yeah, up to some extent … For now. 

Robert Wolpa: And I feel to myself, you understand, I’m 71. I simply turned 71 in November and I’m, I’m slightly, I’ve obtained, I’ve obtained slightly of the HIV cognizant crap. Like my, my brief time period reminiscence is gone.

Dan: After speaking with Robert, this half actually gave me pause. I imply, coping with insurance coverage corporations and all of the attendant hassles is tough work, proper?

It’s not the type of job I’d want on any person as they grow old and begin slowing down. 

And it could possibly be a job that growing numbers of individuals are signing up for: Final yr the variety of folks in Medicare Benefit plans turned the vast majority of folks on Medicare.

Alright, I’ll have scared the bejesus out of you. I’m slightly scared myself. 

However I’ve obtained some super-practical data coming your approach. I talked with considered one of THE greatest folks within the nation to seek out out: What ought to I do know BEFORE it’s time to join Medicare?

Seems the reply is … A LOT. That’s subsequent.

This episode of “An Arm and a Leg” is produced in partnership with KFF Well being Information. That’s a nonprofit newsroom protecting well being care in America. Their reporters, like Sarah Jane Tribble, are wonderful. I’m honored to work with them.

OK, so, if you need conventional Medicare, you just about want to decide on it whenever you first join Medicare. 

And signing up for Medicare seems to contain a LOT of decisions, and loads of completely different value tags.

And a few massive potential pitfalls. It’s wild, the issues I’ve discovered. 

I discovered perhaps the perfect particular person within the nation to study from.

Sarah Murdoch: My identify is Sarah Murdoch. I’m the Director of Consumer Companies on the Medicare Rights Middle, and we’re a nationwide non revenue that assists with Actually any Medicare challenge that you may conceive of and we serve like a large amount of individuals on our helpline, about 20, 000 folks in a yr. 

Dan: What would you need folks to know after they’re like, say, I don’t know, 64, uh, concerning the decisions there? As a result of I feel loads of us suppose, like, “Oh, I’m going to show 65. I’m going to name the federal authorities or perhaps they’ll name me and I by no means have to consider medical insurance once more, or healthcare, or you understand, paying these ridiculous costs.” And I feel that’s not precisely true. Proper?

Sarah Murdoch: To begin off, they’re not going to name you. 

Dan: And never solely do I’ve to name THEM, I’ve to do it on time. Apparently, I get a seven month window — like three and a half months on both aspect of my sixty fifth birthday. And I higher not miss it. 

As a result of if I do, properly, primary: I’ve to attend till the next January to enroll. And until then, I higher have some OTHER medical insurance. As a result of no Medicare for me. 

And never solely that: Once I do enroll, I’m gonna need to pay a penalty. When Sarah advised me this, I used to be like, “are you kidding me?”

Sarah Murdoch: No, I want I used to be kidding, however sadly, sadly not. So yeah, there are very stringent, type of, enrollment home windows that folks want to stay to.

Dan: I type of couldn’t take all of it in directly. I used to be like, “So both I’ve to attend, or else I’ve to pay?” Is that it? Sarah’s like, “no, dummy.”

Sarah Murdoch: You would need to wait AND you would need to pay. So, …

Dan: You’re going to cost me for not having Medicare? That sounds terrible. 

Sarah Murdoch: I really like speaking to folks such as you mentioned after they’re 64 as a result of you may type of head off the pitfalls earlier than they occur.

Dan: Oh, get this: The penalty shouldn’t be a one-time late price. It bumps up what you pay for the remainder of your life. 

Holy crap! I had finished some homework earlier than speaking with Sarah, however I had not seen that one coming in any respect. So yeah. Don’t miss that deadline! And about the remaining, the half I believed I’d finished my homework on, boy did Sarah fill in loads of blanks.

So, simply to get began, right here’s the massive image: Medicare is alphabet soup. There’s half A, that covers hospital payments. There’s half B, that covers physician visits. And there’s half D, for medication.

What’s half C, you’re asking? Oh, that’s Medicare Benefit. For those who’ve obtained that, it mainly takes over for A, B and– loads of the time, D. 

And let’s say you don’t need to go together with Medicare Benefit whenever you first join Medicare, as a result of for most individuals, that is like your one shot at getting conventional Medicare, accepted nearly in every single place, no questions requested.

Then, you’ll want to purchase a Medigap complement, so that you don’t find yourself paying out the wazoo in the event you run into well being issues– as a result of conventional Medicare solely pays 80 %.

However it doesn’t matter what you choose– Medicare Benefit or conventional Medicare … it’s gonna value you. As we heard from Sarah proper on the high of this episode…

Sarah Murdoch: I feel lots of people suppose, Oh, Medicare goes to be free, it sadly shouldn’t be.

Dan: Yeah, so every half has its personal price ticket … Or tags. Sarah walked me via it.

And truly, the very first step includes some GOOD information.

Sarah Murdoch: Half A, which is hospital and inpatient protection is free for most individuals. 

Dan: So, in the event you’ve paid into social safety and medicare for ten years, that’s you. So, nice.

And sadly, that’s the place the simple, easy half… ends. 

Subsequent, we transfer on to Half B — physician payments. Outpatient stuff.

Sarah Murdoch: Half B has a month-to-month premium, uh, of $174… let me simply get the precise, it’s $174 and alter,

Dan: 100 seventy-four {dollars} and seventy cents. 

And essential to notice: Selecting a Medicare Benefit plan does NOT imply you skip paying this half B premium, this 174 {dollars} and seventy cents. It applies to just about all people.

And people with increased incomes — beginning at 103,000 {dollars} — will pay extra. 

OK, that’s half B. Physician visits. On to half D for medication. 

Enjoyable truth: That is 100% run by personal insurance coverage corporations, truly. 

Which, amongst different issues, means it includes looking for a plan. Yearly.

Sarah Murdoch: These plans and their premiums change yr to yr. In New York, like, we’d see them starting from wherever from like $3 month-to-month premium to $120. So in all places.

Dan: $3 sounds good, however I’m guessing there’s a catch.

Sarah Murdoch: Sure, so not each plan is an identical. 

Dan: Some Half D plans cowl extra medication than others. Some go away you paying extra for the medication they do cowl. Which one is an effective deal will rely upon what meds you want.

Ugh, sounds enjoyable, proper? Properly, Sarah tells me there’s truly a bit of excellent information right here, as a result of we’re not on our personal with this.

Sarah Murdoch: Medicare does, on medicare.gov, have a extremely useful gizmo known as “plan finder” the place folks can enter their medicines. It type of matches up your medicines with the plans that cowl them in probably the most reasonably priced approach. 

Dan: It is a big reduction, as a result of procuring alone? Yeesh. It seems like there are 21 completely different Half D plans in my space, so evaluating all of them could be an enormous job. 

OK! Now I’ve obtained Elements A, B, and D. I’m on the hook for, properly begin with $174.70, plus nonetheless a lot for medication. 

And if I nonetheless need conventional Medicare — nearly everybody takes it, hardly any pre-authorizations to fret about — I nonetheless want a Medigap plan. Additionally known as a complement. And, once more, now I’m looking for insurance coverage from personal corporations. 

And guess what? We’ve obtained a complete new bowl of alphabet soup! 

Sarah Murdoch: Yeah. So there’s 10 Medigaps. All of them have a letter. 

Dan: Yeah and every letter has its personal set of advantages and exclusions —some have increased deductibles, others cowl some extras, however they’re all supposed to guard you from paying out the wazoo.

So for instance, Plan G is probably the most complete, and the costliest. And naturally, as soon as I’ve picked a letter, I’m sifting via however-many corporations supply any given plan in my space. 

The place I reside, in Illinois, it seems like there are 57 Plan G’s on supply. Costs: 100 thirty bucks to 4 sixty 4. 

However right here’s one other little bit of excellent information for us. As a result of Sarah has an excellent essential tip.

Sarah Murdoch: I feel it is extremely essential for folks to bear in mind there that each one the G’s are an identical, proper? A G supplied by firm 1 that’s $500, versus the G supplied by firm 2 that’s $300, have an identical advantages, so there’s no motive to choose the, um, costlier. 

Dan: I ask Sarah: Wait. How are any of those corporations getting away with charging extra for the very same factor? Like, why would anyone ever select the costlier one? She’s like, perhaps they only don’t know any higher.

Sarah Murdoch: Perhaps that they had that firm, you understand, after they have been working and so they have, you understand, preconceived notions about it.

Dan: So when folks name the helpline, Sarah and her colleagues inform them …

Sarah Murdoch: Decide one which’s probably the most reasonably priced. Don’t make another choice for no matter motive you may think in your head.

Dan: So in fact it seems within the case of Plan G, which simply occurs to be the instance Sarah’s utilizing, there IS a caveat: In some states, there are Plan G’s bought with a excessive deductible and decrease premiums. Okay, extra to be careful for. However typically, that is some actually good recommendation proper right here.

All of this leaves me with an enormous take-away: 

Medicare shouldn’t be free. There’s that 174 seventy for the Half B premium … after which chances are you’ll be taking a look at a bunch of cash on high of that, for a Medigap plan. 

Or, in the event you go together with Medicare Benefit and keep away from paying for a Medigap plan, you’re looking at coping with personal medical insurance corporations that all of us love a lot.

All of the looking for a plan:  “Do I get an HMO? A PPO? What’s the distinction once more?” 

After which all of the questions, all of the run-arounds, all yr spherical: “Is my physician coated? Is my physician nonetheless coated this yr? Is the corporate gonna approve the care my physician says I want? In the event that they don’t, what the hell am I gonna do?”

All of it left my colleague Sarah Jane Tribble fairly ticked off.

Sarah Jane Tribble: The factor that blew my thoughts is how costly it’s to have any type of Medicare, proper? It’s not a free ticket in your well being care. That is to me, probably the most outrageous factor that you just’re going into retirement, you’ve lived your life, and America is meant to offer you this promise of Medicare, after which the promise is definitely lots of of {dollars} a month.

Dan: Or it can save you some cash by signing up for Medicare Benefit, and hope it really works out for you. 

And hey: It does work for some folks. My mother’s on a Medicare Benefit plan — she’s 93 and positively sees a couple of docs — and he or she’s obtained no complaints. 

Right here’s Sarah Murdoch from the Medicare Rights Middle:

Sarah Murdoch: When folks ask, I feel usually, like, which one is best? It’s like, that’s, that’s not … I can’t reply that as a result of folks’s wants are completely different. Folks’s docs are completely different. The place they reside and their entry to completely different companies could be completely different. For those who’re in a plan that each one your docs take, then that’s nice. It can save you some cash that approach too on these premiums.

Dan: And hope the insurance coverage firm doesn’t change the deal subsequent yr. And that your docs don’t determine to depart the plan. 

OK, I’m not making an attempt to freak you out — or myself. And I even have some excellent news, due to Sarah Murdoch. 

As a result of: We’ve coated loads of floor on what you need to find out about Medicare. However holy crap, there may be SO far more to know. Medigap plans are regulated by states– that’s 50 completely different setups proper there. To not point out the ten completely different flavors of Medigap. And all of the kajillion and one completely different Medicare Benefit plans on the market. 

And there’s offers we haven’t talked about too. Some folks with low incomes qualify for Medicaid, which type of serves as a Medigap. Some folks can get authorities subsidies to cowl that Medicare Half B premium. And, once more, all of that is state-by-state: 50 completely different offers.

So in the event you’re taking a look at truly signing up for Medicare, you’re gonna have much more questions than I can begin to reply right here. 

And the excellent news is: You don’t need to go to an insurance coverage dealer, like Rick and Rob did, and hope they steer you proper as an alternative of, you understand, chasing the next fee.

Sarah Murdoch says each state has an company you may name. They’re known as SHIPS — for State Well being Insurance coverage Help Applications — the A is silent, I suppose. And their job is to offer unbiased recommendation. 

For those who’re in New York, you may even find yourself speaking with Sarah or considered one of her colleagues.

Sarah Murdoch: The SHIPS don’t get something. They don’t have any monetary incentive. We take part within the New York ship, like I don’t care what plan you choose. I simply need to enable you choose one thing that’s going to give you the results you want. And that could be authentic Medicare with a Medigap and Half D. It could be a Medicare Benefit plan. It could be, you understand, Medicare and Medicaid. 

Dan: So if this episode is pitched at somebody who’s at or approaching age 64, the underside line is like, go get on a ship. Go sail on a ship. Is that proper? 

Sarah Murdoch: Yeah. There’s a central web site, shiphelp. org, the place you may simply click on in your state and it’ll type of direct you to the telephone quantity to name. So, they’re there as a useful resource.

This was a LOT. Let’s simply evaluation:

First: Medicare isn’t free. Received it.

Second: Don’t neglect to enroll on time! You may find yourself paying a late price each month for the remainder of your life.

“An Arm and a Leg” is a co-production of KFF Well being Information and Public Highway Productions.

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KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is without doubt one of the core working packages at KFF—an impartial supply of well being coverage analysis, polling, and journalism. Be taught extra about KFF.


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