Get Help with Medicare

Three Great Ways to Learn About Medicare

Medicare & You 2023 is the latest edition of The official U.S. government Medicare handbook. It is carefully written to be as clear and easy to understand as possible. If you are enrolled in Medicare you should have received this 126-page "bible" of Medicare in the mail by the end of September 2022. If not, you can download it here. A Closer Look at Medicare and Related Benefits for New Yorkers 2022 is the equivalent of Medicare & You for New York State. You can download it here.

For guidance on making a decision between Medicare Advantage and Original Medicare, it’s hard to beat ”The Pros and Cons of Medicare Advantage” from Consumer Reports. CR has equally good advice on How to Find the Best Medicare Part D Drug Plan – Consumer Reports and Online Pharmacies that Can Help You Save Big on Prescription Drugs – Consumer Reports.

You can also watch a superb video explanation of Medicare by Eric Hausman, New York’s HIICAP Program Coordinator and expert on all things Medicare for 2023. See it here on New York State Senator Liz Kreuger’s Web Page.

Two Websites You Can Rely On

Medicare.gov is the official government website for Medicare. If you are not enrolled in Medicare and think you qualify, you must sign up through Social Security. If you are enrolled in Original Medicare (Parts A & B), you can use the Medicare Plan Finder to find the cheapest Part D Prescription Drug Plan. Enter the medications you currently take into this online tool, and it will calculate the expected annual costs for all 19 drug plans, including monthly premiums and your out-of-pocket co-payments. You can also use Plan Finder to find a Medicare Advantage Plan that includes Part D Prescription Drug coverage. Go to medicare.gov or call 1-800-MEDICARE (1-800-633-4227) for assistance.

Medicare Interactive provides reliable, user-friendly consumer information on how to use Medicare. You can use the traditional search box at the top of each page to look up information. Or you may want to browse Medicare Interactive’s detailed Table of Contents if you are not sure of your search term. Medicare Interactive is part of the Medicare Rights Center, a non-profit organization and the largest and most reliable independent source of Medicare information and assistance in the United States.

Get Personal Help Over the Phone.

Call Medicare directly at 1-800-MEDICARE (1-800-633-4227). They can help you choose a Medicare Advantage Plan or a Part D prescription drug plan, as well as answer all your questions about Medicare.

The Medicare Rights Center operates a national telephone hotline that fields over 15,000 questions a year. Trained volunteers and staff are available to assist patients in preparing appeals. Call the Medicare Rights Center National Helpline at 1-800-333-4114, Monday through Friday.

New York State Health Insurance Information Counseling and Assistance Program (HIICAP) provides information on low income programs that help pay for Medicare including the Elderly Pharmaceutical Insurance Coverage (EPIC) Program, Medicare Savings Programs, "Extra Help" prescription assistance, and pharmacy discount programs: For more information call HIICAP at 1-212-244-6469 or go here online.

How Medicare Supplements (Medigap) Work in New York.

Within limits set by federal law, individual states set the rules under which Medigap policies are sold. Learn about New York State Medigap rules here.

Wait times for pre-existing conditions for New Yorkers who want to purchase a Medicare Supplement and do not already have a Medicare Supplement or a Medicare Advantage plan can be found here.  Use this online lookup tool to see the latest rates for all Medigap plans in your zip code.

Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare is a 50-page PDF ebook you can download from medicare.gov. It explains this complicated subject as simply as possible. You can download it here.

More About Medicare Advantage

PRIOR AUTHORIZATION AND DENIAL OF CARE

Medicare Advantage Plans Often Deny Needed Care, Federal Report Finds – The New York Times 04-28-22
Medicare Advantage Appeal Outcomes and Audit Findings Raise Concerns About Service and Payment Denials – Office of Inspector General SEP 2018
Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care – Office of Inspector General APRIL 2022 PDF
American Hospital Association Letter Urges CMS to Hold Medicare Advantage Plans Accountable for Inappropriately and Illegally Restricting Beneficiary Access 05-19-22 PDF
2021 AMA prior authorization (PA) physician survey
American Medical Association – Prior authorization hurts patients, physicians, and employers Web Page
Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging | Kaiser Health News 06-29-22
Medicare Advantage Enrollees More Likely To Enter Lower-Quality Nursing Homes Compared To Fee-For-Service Enrollees | Health Affairs JAN 2018
How Insurers Exploited Medicare Advantage for Billions – The New York Times 10-08-22
Private Medicare Plans Misled Customers Into Signing Up, Senate Report Says – The New York Times 11-03-22
Deceptive Marketing Practices Flourish in Medicare Advantage A Report by the Majority Staff of the U.S. Senate Committee on Finance 11-03-22 PDF
Bill in Congress would keep private insurers from using Medicare in their names | JustCare 10-18-22
News You Won’t Hear from Private Plans During Enrollment Season – Center for Medicare Advocacy 10-31-22
Department of Justice sues Kaiser Permanente for coercing employees to upcode Medicare Advantage claims PDF |10-26-21
AARP’s Billion-Dollar Bounty | Kaiser Health News
AARP Consolidated Financial Statements for 2021 and 2020 – PDF
The Dark History of Medicare Privatization – The American Prospect
A Relatively Small Share of Medicare Beneficiaries Compared Plans During a Recent Open Enrollment Period | KFF