Letter to the Editor
Navigating Medicare
Options for Kansas
Seniors and Caregivers
As the Medicare open enrollment period approaches (Oct. 15-Dec. 7), now is the time for Kansas seniors and their families/caregivers to compare the benefits of Original Medicare plans versus Medicare Advantage. Accurate, helpful information is vital to making the best choice about which Medicare option makes the most sense for you or your loved ones.
Medicare Advantage plans—which are privately insured alternatives to Original Medicare—cover all traditional Medicare health services. In addition, they usually include other benefits like vision, dental, and wellness programs. Some plans may offer free or discounted gym memberships or coverage for prescription drugs not included in Original Medicare. However, Medicare Advantage plans are typically limited to a narrower network of doctors and hospitals, and they require pre-authorization for specific services and medications, all of which can delay care, especially in rural areas with fewer in-network provider options.
By contrast, Original Medicare is federally funded and offers extensive access to providers nationwide. Beneficiaries can visit any doctor or hospital that accepts Medicare, which helps ensure access to timely care even in small communities.
Many will notice that Medicare Advantage plans often have lower premiums, but it’s important to realize that doesn’t account for other costs, such as copayments, coinsurance, and deductibles. While the lower premiums may be appealing, the out-ofpocket expenses can add up quickly. A recent Kaiser study found that about half of all Medicare Advantage enrollees pay more for a seven-day hospital stay than those in Original Medicare. Ninety-nine percent of Medicare Advantage plans require approvals and authorizations before care can be given, and according to the Kaiser Family Foundation, 3.4 million Medicare Advantage requested authorizations were denied in 2022.
By understanding the differences and considering all costs and requirements, people who are eligible for Medicare can make informed decisions that best suit their healthcare needs.
If this topic applies to you or someone you care for, resources are readily available to assist you. SHICK is a free program that offers Kansans the opportunity to talk with trained community volunteers and get answers about Medicare and other insurance issues.
A Senior Health Insurance Counselor for Kansas (SHICK) advisor at Northwest Kansas Area Agency on Aging can be reached at (785) 628-8204.
Rooks County Health Center has a SHICK advisor, Anissa Stewart, at (785) 688-4407. You can also visit medicare.gov or call 1-800-MEDICARE to speak to a Medicare representative who can help you understand and compare
Sheila Hachmeister
CFO
Rooks County Health Center
