AILSA CHANG, HOST:
When Medicare open enrollment starts tomorrow, several million seniors will need to scramble to find a new health plan. Their Medicare advantage plans, run by private insurance companies, are shutting down. Dan Weissmann joins us now to explain. He hosts An Arm And A Leg. That's a podcast about the cost of healthcare. And it's distributed by NPR member Station KUOW. Hi, Dan.
DAN WEISSMANN, BYLINE: Hey there.
CHANG: OK, so tell us exactly what is going on here.
WEISSMANN: Yeah. So we should probably start by making a big distinction. Medicare comes in two main flavors these days. So seniors choose between traditional Medicare, run by the federal government, and Medicare Advantage, which is run by private insurance companies. And these days, about half of seniors are on Medicare Advantage plans. They're super popular because they often cover things like vision and dental and hearing, which are big gaps in traditional Medicare. And they tend to cost a lot less out of pocket, like, including lower monthly premiums, because fun fact, Medicare isn't actually free healthcare.
CHANG: Exactly.
WEISSMANN: But there are downsides to these plans, like, for a long time, people have complained, they can limit what doctors you see. They can refuse to pay for treatments. And now we're seeing this new disadvantage. If these companies don't think it's profitable to operate your insurance plan anymore, they don't have to. I mean, they're for-profit companies like, you know, United, Humana, Aetna. They've got shareholders to answer to. So, for 2027, more than 40 states are going to lose some Medicare Advantage plans. And nearly 200 counties, mostly rural, they're going to have no Medicare Advantage options at all.
CHANG: Wow.
WEISSMANN: Yeah.
CHANG: Well, we know that last year about 3 million seniors had to go hunting for new Medicare Advantage plans. I know you and your colleagues have been digging into what happened. What did you learn? And what does that tell us about what might be coming, you think?
WEISSMANN: Yeah, it's going to be rough. We talked with people in Minnesota, where hundreds of thousands of people had to find new plans last year, and where, by the way, more plans are shutting down this year. We talked to Kelli Jo Greiner. She runs a state agency that operates a Medicare hotline there. Here's what she told us.
KELLI JO GREINER: I don't know any other way to describe it other than total chaos. We had wait times of two hours. Nobody wants to wait for even 10 minutes, let alone two hours.
CHANG: No way.
WEISSMANN: Yeah. And when people got through, they generally found out their options were not great, because the plans that had not shut down, they didn't cover as much. They often had higher monthly premiums. And this year, it's basically going to be a lot more of the same in a lot more places. So we crunched some county-level numbers for this coming year based on federal data. These numbers were crunched first by KFF. That's a health policy research group.
What it looks like to us is, like, in the Twin Cities area, a third of the Medicare Advantage plans are shutting down. Dallas-Fort Worth, Houston, Seattle - it's more than a quarter. And official numbers aren't out about how many people are affected. But I'm seeing estimates of, like, 4 to 5 million people across the country losing their plans.
CHANG: Well, if you or someone you care about got one of those letters saying, sorry, your Medicare Advantage plan is shutting down, what do you do? What do you suggest?
WEISSMANN: Yeah, well, first of all, if you or someone you care about is on Medicare Advantage, check your mail. Kelli Jo Greiner, who runs that Medicare hotline in Minnesota, she said she's still hearing from people who missed the notice last year. Doing nothing is not a good choice. You want to know your options. The good news is every state has a hotline like the one she operates. They're part of a federally funded program called SHIP. So if you got any questions, you want to call them now. To find the right one for you, go to Google, type in SHIP and Medicare and the name of your state. The right one should pop right up.
CHANG: Thank you so much for your help. Dan Weissmann is host of An Arm And A Leg, a podcast about the cost of healthcare. Thank you, Dan.
WEISSMANN: Thanks so much for having me. Transcript provided by NPR, Copyright NPR.
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