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In the United States, people have varied opinions about Medicare, many of which are based on hearsay. They are inundated with advertising in the months leading up to “open enrollment” every year, and politicians quarrel about funding. But what is Medicare, and how is it funded? When should a person start thinking about signing up for medical insurance for retirees?
Because of the abundant ad campaigns, most Americans know open enrollment happens during the last three months every year, from mid-October to early December. The ads are funded by insurance brokers hoping to entice the public to buy a Medicare Advantage Plan. “We see people making decisions in 15 minutes [that] they should be taking more time to make,” explained Corey Metzman, the COO and Co-founder of Chapter. Although he suggests people do not wait until the open enrollment period to make coverage changes, “We recommend that people reach out earlier than later.”
If they want to change their coverage, they can speak to a licensed advisor who is not interested in selling a supplemental Medicare policy before October. That way, they can make an informed decision about policy changes and whether or not a change will benefit them. “We’re optimizing Medicare through greater choice and clarity while maximizing cost and complexity,” the Ask Chapter website points out.
Instead of wading through a government website, trying to make sense of the “original Medicare” annual coverage guide, or placing trust in an insurance call center, the Chapter website offers easy-to-use coverage calculators. Advisors will guide people through the process.
With the ever-changing Medicare-related legislation, it is nearly impossible to discover every policy and rider available to the consumer. Metzman explained the Chapter database is “updated within a day or two after public and private sources update their information.
“So, if someone calls in and has a question, we can give them up-to-date recommendations.” Advisors will answer questions and guide consumers to find a policy to provide the best coverage possible, Metzman added.
Medicare History and Expansion
Centers for Medicare and Medicaid Services (CMS) became law when President Lyndon B. Johnson signed the legislation to offer medical coverage to uninsured seniors and people on cash assistance on July 30, 1965. The original Medicare program included Parts A and B, hospital coverage, and medical insurance. Over the years, numerous changes affected eligibility and broadened the program.
In 1972, Medicare was expanded to cover individuals who cannot work due to a long-term disability, end-stage renal disease (ESRD) requiring dialysis or a kidney transplant, and those over 65 who elect coverage.
The Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) provided for private health care plans approved, known as Medicare Advantage Plans, often called Part C or MA Plans. The MMA also allowed for an optional prescription drug benefit, referred to as Part D, that became available in 2006.
“We help people navigate the system. That means we help them decide how and when to sign up for the original Medicare…to see whether or not they need to sign up now to avoid penalties,” Metzman further explained. If they decide that Medicare is better than their current insurance, “then we help people search among all 24,000 coverage options nationwide. It’s an insane number, but it’s because networks of healthcare providers are local, and many contracts vary on a county level.”
Metzman added, “That is what is unique about Chapter. We maintain the only proprietary database of every single Medicare plan nationwide.”
Written by Cathy Milne-Ware
Interview: Corey Metzman, COO and Co-founder of Chapter; July 15, 2022
Chapter: Medicare Made Simple
Kaiser Family Foundation (KFF): FAQs on Medicare Financing and Trust Fund Solvency; by Juliette Cubanski and Tricia Neuman
Business Insider: Senate Democrats want to beef up Medicare by closing a tax break currently used by the rich; by Joseph Zeballos-Roig
Featured and Top Image by CDC Courtesy of Unsplash – Creative Commons License
First Inset Image by Gus Moretta Courtesy of Unsplash – Creative Commons License
Second Inset Image Courtesy of Garry Knight’s Flickr Page – Creative Commons License