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Unravel the mysteries of medicare for readers

April 16, 2019

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Medicare is a complicated topic, but with the number of Americans turning 65, it’s an important topic to cover. Here are a few ideas. (Photo courtesy of Pexels.)

Every day, 10,000 Americans turn 65, which means they qualify for health coverage from Medicare.

The size of that number should get the attention of business reporters, but there’s more: Many new applicants don’t understand Medicare, the federal government’s health insurance program, and make costly mistakes as a result.

In addition, there’s the complacency factor, as noted in a 2017 survey conducted by WellCare Health Plans in Tampa, Florida. Nearly two-thirds (62%) of Medicare beneficiaries don’t review their annual Medicare plans, but take the time to shop for money-saving deals on utilities, cell phone, Internet plans, groceries and other costs.

Prep yourself with these backgrounders from Medicare.gov, AARP, and ehealth insurance.com. Then team with your news organization’s health care reporter to develop a series to explain explains all three of the following angles to your readers:

Surprise! Medicare isn’t free

The Medicare maze might be told effectively in an online or video “Q-&A,” or even as a quiz, to lighten up the discussion. Check out these 38 Medicare facts from quizlet.com. But health care coverage costs in retirement are no laughing matter.

Fidelity’s annual survey on health care costs estimates that a 65-year-old couple retiring in 2019 will need $280,000 to pay for health care costs in retirement. There are annual deductibles to meet for both Part A (hospital stays, skilled nursing, hospice and some home health services) and Part B (outpatient care and medical supplies) before services are covered; there is also a monthly premium for Part B. Both parts pay only 80% of costs, and can cap, or limit, benefits, which means buying additional coverage, known as “medigap,” to supplement Traditional Medicare, or signing up for a “Medicare Advantage” plan that combines Medicare and supplemental coverage.

Neither Part A or Part B, however, covers the cost of prescription drugs. Failing to sign up this coverage on time triggers the next angle to untangle for your readers:

Sign up on time or pay lifelong penalties

To drive this story home, search for those in your zip code who failed to sign up for Medicare and prescription drug coverage on time and are paying the penalties. The annual penalty for Part A is 10%, and it doubles for every year you delay signing up on time.

Failing to sign up for prescription drug coverage, however, triggers a lifetime penalty: 10% a year you failed to enroll, which is tacked onto your monthly premium.

Don’t assume you’re automatically enrolled

Play out different scenarios to explain this Medicare mystery. Have a health insurance professional or two to help answer questions in a video presentation. Medicare cards can show up automatically in the mail, if beneficiaries start collecting Social Security benefits before 65.

Those still working must call the Social Security Administration and ask not to be enrolled. But coverage varies depending on the size of the company. Those working in a company with 20 or more employees can delay signing up for Medicare without facing late-enrollment penalties; in company with fewer than 20 employees must sign up for Medicare, which becomes their primary insurance.


  • Dorianne Perrucci

    Since 2001, Dorianne's freelance bylines have appeared in leading print and digital news outlets, including The New York Times, Newsweek, The Wall Street Journal, TheStreet.com, The Star-Ledger and NJ Biz. During the financial crisis of 2007-2009, Do...

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