{"id":8787,"date":"2023-11-20T21:20:47","date_gmt":"2023-11-20T21:20:47","guid":{"rendered":"https:\/\/topat10.com\/rampant-confusion-about-medicare-is-bad-for-your-health-and-costing-you-money-experts-help-make-sense-of-coverage-and-fees\/"},"modified":"2023-11-20T21:20:47","modified_gmt":"2023-11-20T21:20:47","slug":"rampant-confusion-about-medicare-is-bad-for-your-health-and-costing-you-money-experts-help-make-sense-of-coverage-and-fees","status":"publish","type":"post","link":"https:\/\/topat10.com\/?p=8787","title":{"rendered":"Rampant confusion about Medicare is bad for your health and costing you money. Experts help make sense of coverage and fees"},"content":{"rendered":"\n

Since it\u2019s Medicare Open Enrollment <\/a>season, you\u2019re likely seeing a host of TV commercials for private insurers\u2019 Medicare Advantage plans and mailers to enroll in them and in Medicare Part D prescription drug plans<\/a>. So, you might think people 65 and older would be especially sharp about all things Medicare.<\/p>\n

\n

Wrong.<\/p>\n

In fact, several recent surveys show that most Medicare beneficiaries are quite confused about Medicare\u2019s coverage and costs.<\/p>\n

For example, in a MedicareAdvantage.com survey<\/a> of 2,013 people aged 65 to 99, 65% of Medicare beneficiaries said the government\u2019s health insurance program was confusing and difficult to understand. This is the third year the site conducted a similar survey and confusion about Medicare abounded each time.<\/p>\n

Medicare confusion: \u2018surprising and troubling\u2019<\/strong><\/h2>\n

\u201cIt\u2019s equal parts surprising and troubling,\u201d says Christian Worstell, who conducted the recent survey. \u201cI write about Medicare as my full-time job, and I agree that it is confusing. Imagine how confusing it is for someone not reading about it, researching it and writing about it every day.\u201d<\/p>\n

In a Retirement Living survey<\/a> of 351 beneficiaries of private insurers\u2019 Medicare Advantage plans<\/a> (the alternative to Original Medicare), only 44% say they fully understand their plan. One in eight misinterpreted aspects of their plan after enrolling.<\/p>\n

But, Worstell says, \u201cknowledge is power when it comes to making the most of your benefits and enrolling in the right coverage that fits your needs.\u201d<\/p>\n

When Medicare beneficiaries or people about to enroll in Medicare don\u2019t understand how it works, they can wind up paying more for their health care than necessary and miss out on getting the coverage that\u2019s available to them.<\/p>\n

In fact, Retirement Living\u2019s survey found that 51% of Medicare Advantage beneficiaries said their confusion led to unexpected bills for uncovered services and 46% said they had higher than expected out-of-pocket costs.<\/p>\n

Ari Parker, co-founder of the Medicare advisory service Chapter, is also surprised how little older Americans know about Medicare.<\/p>\n

\u201cIf they know where to turn to find information, it\u2019s not that complicated,\u201d he says.<\/p>\n

Medicare<\/strong>\u2018s many moving parts<\/h2>\n

Others may disagree about Medicare not being that complicated. Consider:<\/p>\n

The original Medicare law and subsequent rules are massive. <\/strong>According to Parker\u2019s own book, It\u2019s Not That Complicated: The Three Medicare Decisions to Protect Your Health & Money<\/em><\/a>, the 1965 law creating Medicare was over 1,400 pages and tens of thousands of pages of rules and regulations have been added since then. Parker wrote that when President Lyndon Johnson tried to explain his new Medicare program to journalists, he mangled it so much that the White House Press Secretary had to get the media to retract his description.<\/p>\n

Medicare is like a train running on two tracks.<\/strong> One is Original Medicare, which includes Part A (hospital insurance)<\/a> and Part B (doctor\u2019s visits, home health care, medical equipment and preventive services)<\/a>. The other is Medicare Advantage (Part C)<\/a>, which includes coverage Original Medicare doesn\u2019t with a limited network of doctors and hospitals. There will be 3,959 Medicare Advantage plans nationwide in 2024; the average Medicare beneficiary will have access to 43, according to the health policy research and news organization, KFF.<\/p>\n

You need to understand all of Medicare\u2019s Parts\u2014A<\/a>, B<\/a>, C<\/a> and D<\/a>. <\/strong>To get Part C or D, you need to shop among health insurers and compare costs and benefits. There will be 709 stand-alone prescription drug plans for people with Original Medicare in 2024; the average beneficiary will have a choice of nearly 60, says KFF.<\/p>\n

Then there\u2019s another insurance policy you can buy to help pay for what Parts A and B don\u2019t.<\/strong> It\u2019s a Medicare Supplement policy, or Medigap, and you need to shop around if you want it, too.<\/p>\n

Plus, Medicare has five enrollment periods: Open Enrollment<\/strong> from Oct. 15 through Dec. 7; Initial Enrollment <\/strong>(three months before you turn 65 through three months after your birthday month); the eight-month Special Enrollment<\/strong> after you lose health insurance from your employer or your spouse\u2019s and the two periods from Jan. 1 to March 31\u2014General Enrollment,<\/strong> if you didn\u2019t sign up for Medicare Part B during Initial Enrollment and don\u2019t qualify for Special Enrollment and Medicare Advantage Enrollment<\/strong>, if you\u2019re in a Medicare Advantage plan and want to switch to another or drop it and enroll in Original Medicare.<\/p>\n

As Worstell says: \u201cThere\u2019s a lot of moving parts; ifs, ands and buts. There are lot of terms and exceptions. \u2018Does Medicare cover this? Well, yes, but only if the following 11 things are true.\u201d<\/p>\n

Worstell notes that health insurance itself can be confusing and the Medicare overlay only adds to the public\u2019s insurance literacy problems.<\/p>\n

What people don\u2019t know about Medicare<\/strong><\/h2>\n

So, what are people eligible for, or on, Medicare confused or wrong about? Here are six examples:<\/p>\n

\n

1. Deductibles<\/strong><\/h3>\n

A full 49% of Medicare beneficiaries surveyed by MedicareAdvantage.com think Medicare doesn\u2019t charge a deductible (what you pay out of pocket before coverage kicks in) for inpatient care. It does.<\/p>\n

The Part A deductible will be $1,632 and the Part B one will be $240. Part C deductibles vary based on the Medicare Advantage plan. \u201cI think you definitely want to know before you go to the hospital that you are going to be on the hook for $1,600,\u201d says Worstell.<\/p>\n<\/div>\n

2. Doctor\u2019s fees<\/strong><\/h3>\n

When current beneficiaries or people about to enroll in Medicare don\u2019t understand how it works, they can wind up paying more for their health care than necessary. This is called an \u201cexcess charge\u201d and can be up to an extra 15% of the doctor\u2019s bill.<\/p>\n

3. Mental health benefits<\/h3>\n

More than two-thirds (71%) of them don\u2019t know Medicare covers inpatient and mental health treatment. \u201cIt\u2019s troubling to think how many people might need mental health treatment and are not seeking it out because they think it won\u2019t be covered by Medicare and don\u2019t want to have to pay for it out of pocket,\u201d says Worstell.<\/p>\n

4. Assisted devices<\/h3>\n

Only 29% knew that Original Medicare typically covers walkers, rollators, and wheelchairs. \u201cI think most people don\u2019t really associate equipment and devices with insurance,\u201d Worstell says.<\/p>\n

5. Plan changes<\/h3>\n

In a survey<\/a> of people 65+ from The Commonwealth Fund, 54% weren\u2019t sure how difficult it was to switch from Medicare Advantage to traditional Medicare and get a Medigap policy. Another 21% didn\u2019t know that was even an option.<\/p>\n

6. Out-of-pocket costs <\/h3>\n

A 2023 KFF survey<\/a> found only 34% of people 65+ knew there\u2019s a federal law (2022\u2019s Inflation Reduction Act) that limits out-of-pocket prescription drug costs for people with Medicare.<\/p>\n

Learning the ins and outs of Medicare can be intimidating and \u201cit\u2019s not fun,\u201d Worstell says. \u201cNobody likes to sit down and weed through all these benefits and costs,\u201d he adds.<\/p>\n

Where to Learn About Medicare<\/strong><\/h2>\n

There are quite a few places to bone up on Medicare, though beneficiaries rarely use many of them, according to the MedicareAdvantage.com survey.<\/p>\n

Some of the best Medicare resources<\/h3>\n

Medicare.gov.<\/strong><\/a> <\/strong>This is the official government site that explains how Medicare works and how to enroll or switch plans. It also has the useful Medicare Plan Finder<\/a> tool that lets you find and compare Medicare Advantage plans, Part D drug plans and Medigap policies.<\/p>\n

1-800-MEDICARE<\/strong> (800-633\u20134227<\/strong><\/a>). It\u2019s Medicare\u2019s toll-free number where you can speak to a human to get questions answered. A Medicareadvantage.com article about it says the fastest way to get through this toll-free number\u2019s phone tree to get assistance is to say \u201cCoverage and Benefits\u201d or press 5 on your phone keypad.<\/p>\n

The government\u2019s free<\/strong> <\/strong>Medicare & You 2024<\/strong><\/a> handbook<\/strong>. You can read it online or get a copy mailed to you. This guide is written in plain English and has a useful index.<\/p>\n

State SHIP programs<\/strong><\/a>. SHIPs (full name: State Health Insurance Assistance Programs) offer free, unbiased phone help about Medicare from state government experts.<\/p>\n

Medicare brokers and agents<\/strong><\/a>.<\/strong> They sell Medicare Advantage plans, Part D prescription drug plans and Medigap policies and are paid by the insurers.<\/p>\n

Medicare books and websites<\/strong>. Three useful books are Medicare for You<\/em><\/a> <\/em>by Diane Omdahl, Get What\u2019s Yours for Medicare<\/em><\/a> by Philip Moeller and It\u2019s Not That Complicated<\/em><\/a> by Ari Parker. Websites worth checking out are ones from Chapter<\/a>, which has a free Medicare Decision Worksheet<\/a> you can download) and Hello Medicare<\/a>; both sites also sell Medicare policies.<\/p>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"

Since it\u2019s Medicare Open Enrollment season, you\u2019re likely seeing a host of TV commercials for private insurers\u2019 Medicare Advantage plans and mailers to enroll in them and in Medicare Part D prescription drug plans. So, you might think people 65 and older would be especially sharp about all things Medicare. Wrong. In fact, several recent […]<\/p>\n","protected":false},"author":140,"featured_media":8788,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[123],"tags":[],"class_list":["post-8787","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-business"],"yoast_head":"\nRampant confusion about Medicare is bad for your health and costing you money. 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So, you might think people 65 and older would be especially sharp about all things Medicare. Wrong. 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