Dan Weissmann

Medicare could sound like an escape from the costly world of U.S. medical health insurance, nevertheless it’s extra difficult, and costly, than many notice. And choices seniors make after they join the federal medical health insurance program can have enormous penalties down the street. 

Host Dan Weissmann speaks with Sarah Jane Tribble, KFF Well being Information’ chief rural well being correspondent, about one of many largest 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 decide the plan that’s proper for them.

Dan Weissmann

@danweissmann

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

Credit

Emily Pisacreta
Producer

Adam Raymonda
Audio wizard

Ellen Weiss
Editor

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Transcript: The Medicare Episode

Notice: “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 test 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. You recognize, that free-health-care factor you might count on to get once you flip 65.

It’s been on an inventory of issues the place I’ve been like, “that’s TOO huge, and TOO difficult. I can’t get my arms round that simply now.” 

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

I’ve been like, Perhaps sometime.

And that sometime? That’s at the moment. Or at the very least, we begin at the moment. 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 title 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 people 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 they usually’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 assume. 

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 resolution, it occurs once you first enroll.

And right here’s the massive factor that Sarah Jane realized: should you join Medicare Benefit, at that time, once you first get on Medicare, you’re just about caught with it. And a few individuals find yourself with purchaser’s regret. Large time.

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

And there’s been loads of questionable data that comes at individuals. TV exhibits that older people watch have been filled with advertisements with Folks Who Had been Actual Well-known within the Nineteen 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 vital message. I’ve been on Medicare for longer than I’ll admit, and it positive has modified. 

Dan: A few of these advertisements 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 test. 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 advertisements like these. 

So understanding what’s occurring, it’s a giant deal. We’ll run down what I’ve realized up to now, together with some extraordinarily professional steerage. 

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

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

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

So by the point we’re accomplished, you’re gonna perceive the distinction between Medicare Benefit and conventional Medicare — and easy methods to begin sorting by means of the alphabet soup.We’ll additionally depart you with some stable assets to determine what your best option is perhaps when the time comes, both for you or anyone 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 are able to 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 components of American life, and convey you one thing entertaining, empowering, and helpful.

OK, in relation to Medicare, the most important selection people must make is between conventional Medicare — run immediately 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 provide 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 combating with these insurance coverage corporations to receives a commission. And generally 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 really don’t take your plan.” And so that you’ve acquired these small city, you recognize, people who’ve just one hospital and an extended, you recognize, giant radius. And they’d present up and the hospital can be like, “Ah, you’re going to must pay out of pocket as a result of we don’t take this Medicare Benefit plan.” And the affected person, after all, can be like, “however I’m on Medicare, you’re speculated to maintain me.”

Dan: Yeah. Isn’t that cope with Medicare? Everyone 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 really have an effect on the care you get?

Dan: And the reply looks as if: Perhaps so much. 

Just a little Google looking out 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 Providers. 

And should you’ve acquired common insurance coverage, you might be conversant in what’s referred to 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 assume you want … a take a look at, a process, a prescription. 

And generally 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 recognize, as you become older, should you acquired sick, you might have eight of those requests in a month. 

Sarah Jane began speaking with sufferers.

Sarah Jane Tribble: I referred to as one gentleman in Washington state, and he wished 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 residing 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, form 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 stated, you recognize, the very best factor to do is to get a Medicare Benefit plan as a result of they cowl all the things, and it’s, it’s far cheaper than conventional Medicare,

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

And even when it’s not, why ought to … I imply, how might … 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 all the things and also you’re on the hook for the opposite 20 %. There’s no out-of-pocket restrict. Let’s deliver again Sarah Jane Tribble to briefly say what which means: 

Sarah Jane Tribble: You could possibly pay out the wazoo. It might bankrupt you. 

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

To keep away from that danger, should you’re on conventional Medicare you principally want one other insurance coverage coverage — a complement, usually referred to as Medigap — prefer it covers the gaps that conventional Medicare leaves. 

Some individuals get Medigap from their outdated employers. However most individuals must pay for it. It might probably 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 typically DO cowl these issues. 

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

Rick Timmins: Principally what he stated was, yeah, if you wish to join conventional Medicare, I might help you for that, however if you would like Medicare Benefit, which is a a lot 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 stated, you must get that checked out. I’ve a household historical past of melanoma. My two sisters have had melanoma.

Dan: Rick says he noticed his major care doc, then began making an attempt to get his insurance coverage firm’s promise that seeing a specialist can be lined. He says he referred to as and referred to 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 recognize, I used to be frightened. It’s like you’ll be able to’t take into consideration the rest once 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, minimize 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 stated 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 after all to modify to conventional Medicare, Rick would wish a complement, a Medigap coverage.

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

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

However Rick doesn’t assume 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 must problem you a Medigap coverage when you’ve got pre-existing circumstances. 

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

Rick Timmins: The insurance coverage corporations can inform me, no, we don’t wish 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 placing to Sarah Jane Tribble.

Sarah Jane Tribble: It’s form of stunning, really, 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 would possibly want that probably the most, who’re 65 and older. 

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

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

Dan: I talked to another person who would love do-overs on signing up for Medicare Benefit. Within the Nineteen 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 acquired inundated with advertisements and calls and flyers.

Robert Wolpa: I acquired 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 acquired 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 recognize, it’s one factor to must name to get a pre-authorization or a referral. “Is that this physician lined? No. Oh okay. Which physician is roofed?” It’s loads of calls. After which there’s the problem of getting by means of the calls.

Robert Wolpa: It acquired more durable and more durable 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 individuals. I imply they’re so undertrained and underpaid.

Dan: At the very 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 acquired 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 stated, okay. Subsequent choice. 

Dan: I counsel perhaps his work background offers him a bonus in leaping by means of hoops, like making all these calls: each realizing easy methods to navigate, and having empathy that would assist him preserve his blood stress from spiking too laborious. He says, yeah, up to a degree … For now. 

Robert Wolpa: And I feel to myself, you recognize, I’m 71. I simply turned 71 in November and I’m, I’m slightly, I’ve acquired, I’ve acquired slightly of the HIV cognizant crap. Like my, my quick 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 anyone as they become older and begin slowing down. 

And it may very well be a job that growing numbers of individuals are signing up for: Final yr the variety of individuals in Medicare Benefit plans turned nearly all of individuals on Medicare.

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

However I’ve acquired some super-practical data coming your method. I talked with certainly one of THE finest individuals within the nation to search out out: What ought to I do know BEFORE it’s time to enroll in 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 masking well being care in America. Their reporters, like Sarah Jane Tribble, are superb. I’m honored to work with them.

OK, so, if you would like conventional Medicare, you just about want to decide on it once 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 huge potential pitfalls. It’s wild, the issues I’ve realized. 

I discovered perhaps the very best particular person within the nation to be taught from.

Sarah Murdoch: My title is Sarah Murdoch. I’m the Director of Consumer Providers on the Medicare Rights Heart, and we’re a nationwide non revenue that assists with Actually any Medicare problem that you might conceive of and we serve like a large amount of individuals on our helpline, about 20, 000 individuals in a yr. 

Dan: What would you need individuals to know after they’re like, say, I don’t know, 64, uh, in regards to the decisions there? As a result of I feel loads of us assume, 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 health insurance once more, or healthcare, or you recognize, paying these ridiculous costs.” And I feel that’s not precisely true. Proper?

Sarah Murdoch: To start out 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, nicely, primary: I’ve to attend till the next January to enroll. And until then, I higher have some OTHER medical health insurance. As a result of no Medicare for me. 

And never solely that: After I do enroll, I’m gonna must pay a penalty. When Sarah informed 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 individuals 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 like speaking to individuals such as you stated after they’re 64 as a result of you’ll be able to type of head off the pitfalls earlier than they occur.

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

Holy crap! I had accomplished 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 assumed I’d accomplished 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 medicine.

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

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

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

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

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

Dan: Yeah, so every half has its personal price ticket … Or tags. Sarah walked me by means of 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, should 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 vital to notice: Choosing 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 everyone.

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

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

Enjoyable truth: That is one hundred pc run by personal insurance coverage corporations, really. 

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 might see them starting from anyplace 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 medicine than others. Some depart you paying extra for the medicine they do cowl. Which one is an effective deal will depend upon what meds you want.

Ugh, sounds enjoyable, proper? Effectively, Sarah tells me there’s really 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 very useful gizmo referred to as “plan finder” the place individuals can enter their drugs. It form of matches up your drugs with the plans that cowl them in probably the most reasonably priced method. 

Dan: It is a enormous aid, as a result of purchasing by myself? Yeesh. It seems to be like there are 21 completely different Half D plans in my space, so evaluating all of them can be a giant job. 

OK! Now I’ve acquired Elements A, B, and D. I’m on the hook for, nicely begin with $174.70, plus nevertheless a lot for medicine. 

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 referred to as a complement. And, once more, now I’m looking for insurance coverage from personal corporations. 

And guess what? We’ve acquired 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 greater 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 most costly. And naturally, as soon as I’ve picked a letter, I’m sifting by means of however-many corporations provide any given plan in my space. 

The place I stay, in Illinois, it seems to be like there are 57 Plan G’s on provide. 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 vital tip.

Sarah Murdoch: I feel it is vitally vital for individuals to remember there that each one the G’s are an identical, proper? A G provided by firm 1 that’s $500, versus the G provided by firm 2 that’s $300, have an identical advantages, so there’s no cause to select 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 simply don’t know any higher.

Sarah Murdoch: Perhaps they’d that firm, you recognize, after they have been working they usually have, you recognize, preconceived notions about it.

Dan: So when individuals 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 cause you may think in your head.

Dan: So after all 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 generally, that is some actually good recommendation proper right here.

All of this leaves me with a giant take-away: 

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

Or, should you go together with Medicare Benefit and keep away from paying for a Medigap plan, you’re looking at coping with personal medical health 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 lined? Is my physician nonetheless lined this yr? Is the corporate gonna approve the care my physician says I would like? 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 on 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 a whole lot 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 individuals. My mother’s on a Medicare Benefit plan — she’s 93 and undoubtedly sees a couple of docs — and she or he’s acquired no complaints. 

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

Sarah Murdoch: When individuals 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 individuals’s wants are completely different. Folks’s docs are completely different. The place they stay and their entry to completely different providers is perhaps 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 method too on these premiums.

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

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

As a result of: We’ve lined loads of floor on what you must learn about Medicare. However holy crap, there’s 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 individuals with low incomes qualify for Medicaid, which type of serves as a Medigap. Some individuals 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 should you’re taking a look at really 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 must go to an insurance coverage dealer, like Rick and Rob did, and hope they steer you proper as a substitute of, you recognize, chasing a better fee.

Sarah Murdoch says each state has an company you’ll be able to name. They’re referred to as SHIPS — for State Well being Insurance coverage Help Packages — the A is silent, I assume. And their job is to offer unbiased recommendation. 

For those who’re in New York, you would possibly even find yourself speaking with Sarah or certainly 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 decide. I simply wish to enable you to decide one thing that’s going to be just right for you. And which may be unique Medicare with a Medigap and Half D. It is perhaps a Medicare Benefit plan. It is perhaps, you recognize, 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’ll be able to 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 overview:

First: Medicare isn’t free. Received it.

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

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

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