Covering Medicare from the patient perspective
By Alex Rosenberg/Wisconsin Health Journalism Fellow
Expert panelists at HJ26 referred to Medicare as complicated, complex and difficult. They recommended stories reporters could write to offer clarity and help beneficiaries better understand the federal health insurance program for people 65 and older and those with certain disabilities.
“It’s an incredible array of plan options that people need to look at and make sure their providers participate, their drugs are covered and they are going to be able to afford the plan,” said Kelli Jo Greiner, director of Minnesota’s State Health Insurance Assistance Program (SHIP), a grant-funded program that helps people navigate Medicare and related health care issues.
SHIPs help millions of beneficiaries every year, often with fundamental questions about Medicare, Greiner said. People reach out wondering how to sign up for the program, what to do if they continue to work past 65, what their plan will cost and what to do if they can’t afford Medicare premiums.
The Commonwealth Fund’s Gretchen Jacobson at HJ26. Photo by Zachary Linhares
Susan Jaffe at HJ26. Photo by Zachary Linhares
About 5% of beneficiaries reported using a SHIP for help choosing a Medicare plan, according to a 2022 survey by the Commonwealth Fund, a nonprofit, nonpartisan research and grantmaking organization. Many more people surveyed found plans through insurance brokers, friends and family, or said they didn’t receive help.
Reporters’ stories could highlight Medicare resources. Working with a SHIP is free and, unlike some insurance companies and brokers, SHIPs’ advice is unbiased. “We do not sell or market any product whatsoever,” Greiner said. SHIPs in every state and several U.S. territories are listed on shiphelp.org.
There is other free, widely available help for older Americans, too. Genevieve Gaboriault, deputy ombudsman for long-term care at Minnesota’s Office of the Ombudsman for Long-Term Care, gave a tutorial on their program. Similar to SHIPs, there are government-funded long-term care ombudsmen throughout the country.
Reporters can get the word out about these advocates, which provide information about nursing homes, other residential care options and home- and community-based services. There are also story opportunities around long-term care issues ombudsmen help with, such as understaffing, poor performance, private equity ownership and differing regulations between facility types.
Gretchen Jacobson, vice president of Medicare, expanding coverage and access at the Commonwealth Fund, provided some of the organization’s data to inform additional stories.
For example, 88% of Medicare Advantage beneficiaries said plans’ access to supplemental benefits is important when choosing a plan, according to a 2023-2024 Commonwealth Fund survey. Still, 31% reported not using supplemental benefits over the past year. Reporters could investigate that gap and report on how people shop for plans and why some aren’t fully using their benefits.
Jacobson also noted that billions of taxpayer dollars pay for those supplemental benefits. The costs, trade-offs and politics of that government spending could offer opportunities for policy-focused reporting.
With over 70 million beneficiaries and nearly $1 trillion in federal spending, Medicare offers a lot of fertile ground for reporting. And as an increasing number of baby boomers age into the program, demand for more and better information is only likely to grow.
Alex Rosenberg covers Medicare and other types of insurance for NerdWallet.
