The Case for Making Medicare More Understandable: Insight From Founder of Milwaukee-Based '65 Incorporated'

There are many pieces to the Medicare puzzle. To solve it, our nation needs creative minds — both in the public and private sectors — to collaborate on a solution that fixes many of the system’s inefficiencies.

My Mequon-based Medicare information resource company, 65 Incorporated, recently unveiled findings from a startling survey we conducted. It revealed confusion among Medicare users that has reached epidemic proportions.

We polled hundreds of Medicare beneficiaries nationwide to ask them what they knew about their coverage. The results tell a sobering story.

Our findings show that 30 percent of Americans 65 and over who say they understand all or a majority of Medicare cannot identify their coverage type. This may be the reason why so many people fail to choose the right plan, which winds up costing them unnecessary money, time and frustrations.

Just as startling, our study indicates the government’s 1-800-Medicare helpline leaves many senior citizens deeply perplexed. The people we polled who used it were 80 percent more likely to have had a difficult time dealing with Medicare compared to those using another resource.

When taking into account all government resources — including web-based, in-person or printed literature — seniors were still 35 percent more likely to have had a difficult time dealing with Medicare compared to those who didn’t receive their information from the government.

This shows the demand for a more thorough way of relaying to seniors their Medicare options. I am dedicated to making Medicare information more clear and concise for the millions of Baby Boomers enrolling, and that’s why I’ve launched 65 Incorporated.

Several Key Medicare Changes to Keep in Mind:

• The Affordable Care Act has reduced payments to Medicare Advantage plans to bring the costs more in line with “Original” or “Traditional” Medicare. Plans are responding in ways that consumers may not notice, which could have significant repercussions.
• One trend we’re seeing both nationally and locally here in the Milwaukee area is a strong surge in HMO plans and the virtual elimination of HMO-POS plans.
• These new HMO plans are zero, or very low premiums. However, a health maintenance organization can be restrictive because it requires a referral from a network primary physician to see a specialist — and the plans generally won’t pay for out-of-network care except in a true emergency.