"Medicare Denied Your Procedure — Now What?"

December 13, 2023

Medicare Advantage plans denied or partially denied 2 million requests for prior authorization for medical services in 2021, according to a 2023 analysis from KFF, a health policy nonprofit. Prior authorization is often required for more expensive services, such as chemotherapy or stays in a skilled nursing facility. Denials can also happen after a procedure. “Last year, we got a call from a woman who got a knee replacement without prior authorization,” says Diane Omdahl, president and co-founder of 65 Incorporated, which offers Medicare guidance. “It was denied after the fact, and she was looking at a $62,000 bill.”

"Insulin users beware: your Medicare drug plan may drop your insulin. What it means for you"

November 30, 2023

With Medicare annual open enrollment about to close on Dec. 7, Medicare experts are discovering many insurance plans are dropping some insulin coverage in 2024. In an informal survey of 22 Medicare plans, 10 plans are dropping at least one insulin from their formulary, according to Diane Omdahl, founder of 65 Inc., which provides Medicare enrollment guidance through fee-for-service, one-on-one consultations. Four plans are dropping four or more different insulins, she said.

"Shopping for Medicare Advantage: 6 Pitfalls to Avoid"

October 2, 2023

Only 3 in 10 Medicare beneficiaries shop around during open enrollment, according to a 2022 analysis from KFF, a health policy nonprofit — and only 1 in 10 Medicare Advantage enrollees voluntarily switch plans.“You are essentially taking the Medicare coverage that you’ve been provided by the government and turning that in,” says Melinda Caughill, co-founder and CEO of 65 Incorporated, which offers Medicare guidance.

"Medicare open enrollment for 2024 is coming soon. Here's when it is and how to prepare."

October 2, 2023

More than 65 million Americans will soon be bombarded with ads for Medicare health care plans whose open enrollment period begins Oct. 15 and runs through Dec. 7. Each year, Medicare health and drug plans can change things like cost, coverage, and what providers and pharmacies are in their networks. Check premiums and out-of-pocket maximums. A word of caution: Medicare Advantage plans often tout $0 premiums or low premiums. But those figures should be balanced with out-of-pocket expenses, which can be higher than in Medicare supplement plans used with original Medicare, said Diane Omdahl, founder of 65 Incorporated.

"How to lower your Medicare costs during open enrollment for 2024"

September 21, 2023

Medicare open enrollment season is approaching—Oct. 15 to Dec. 7—when you can join, switch, or drop a Medicare Part D prescription drug plan or a private insurer’s Medicare Advantage plan for 2024. Experts say it’s vitally important to explore your options carefull. If you wait to compare plans in January, says Diane Omdahl, president of 65 Incorporated, a Medicare advisory firm, “it’s too late.”

"How to Decide Between Medicare and Medicare Advantage When You Turn 65"

September 16, 2023

Each year, millions of Americans turn 65 and face a key decision that will affect their healthcare spending for the rest of their life: Medicare or Medicare Advantage. Melinda Caughill, co-founder of Medicare advisory 65 Incorporated, points to a former client who died of cancer at 70 after a long, unsuccessful struggle to get her Medicare Advantage plan to let her see the specialists who she thought could save her life. She took advantage of a quirk in Medicare rules: If you move away from your Medicare Advantage territory you can get Medigap insurance without underwriting—even if you are already ill.

"Here’s why you shouldn’t ignore Medicare open enrollment"

October 23, 2023

Medicare beneficiaries have a slim window to review and improve their coverage options and potentially save money for 2023 during open enrollment. “Everything about your coverage can change — premiums, deductibles, out-of-pocket maximums, provider networks, pharmacy networks — even though it's the same plan name,” Melinda Caughill, co-founder of the Medicare advice website 65 Incorporated, told Yahoo Money. “It’s scary, but people don’t know that.”

"Divorce After 60: What Happens to Your Health Benefits?"

Divorcing as you near retirement — or after you’ve retired — comes with considerations: Are you (or your spouse) losing health insurance? If you’re retired but not yet eligible for Medicare, where will you find coverage? How does being an ex-spouse affect your Medicare costs? If you know when your coverage will end, take action beforehand, says Melinda Caughill, co-founder and CEO of 65 Incorporated, which offers guidance on Medicare. “That’s ideal to avoid a gap in coverage,” she says.

"How to Get a Replacement Medicare Card"

If you need to get a Medicare replacement card, don’t worry. It’s an easy process. These tips and tricks will make getting a replacement Medicare card as straightforward as possible. “I ordered a replacement card, and it took so long by mail, I forgot about it,” says Diane J. Omdahl, co-founder of 65 Incorporated, a Mequon, Wisconsin-based firm focused on Medicare advice.

"Does Medicare cover Ozempic, Wegovy, and other drugs taken for weight loss?"

June 23, 2023

About 30% of people 65 and older in the U.S. have obesity, and there are many more eager to lose weight. Here’s what you need to know about Medicare coverage for prescription drugs taken for weight loss, including ones like Ozempic that aren’t approved by the FDA for that purpose.

"Medicare essentials for stay-at-home women"

June 19, 2023

In this article, Diane explores the challenges faced by women without long work histories and how they can navigate Medicare to ensure comprehensive healthcare coverage during retirement.

"Does Medicare pay for Alzheimer’s drugs? The answer is complicated and changing"

June 15, 2023

"Diane Omdahl, author of Medicare for You and CEO of the Medicare advisory firm 65 Incorporated, says a registry “is definitely going to be an impediment to people being able to get” Alzheimer’s drugs.

Roughly 6.7 million Americans age 65 or older are living with Alzheimer’s disease, and many of them could benefit from treatments that could slow the progression of disease. Here’s what you need to know about Medicare covering treatments and medications related to Alzheimer’s."

"Many insured older Americans face unpaid medical bills"

June 11, 2023

Medical debt for older Americans with health insurance is on the rise. Nearly four million older adults could not pay their medical bills in full in 2020, the latest year that such data is available, per this report. Over two-thirds of those with unpaid bills had coverage from more than one source such as Medicare, Medicare Advantage, Medicaid, Medigap, employer-based coverage, or Tricare, the overall military health plan. Diane Omdahl offers some insights on how to steer clear of medical debt."

"Entrepreneur and Former Nurse Finding and Leading the Way for Seniors"

June 6, 2023

"Navigating the complexities of Medicare enrollment can be overwhelming and even daunting for the millions of Americans turning 65 each year. Making a single mistake during this process can result in significant financial consequences. By understanding the timing, coverage options, plan selection criteria, enrollment methods, and the importance of annual plan reviews, you can ensure your clients avoid costly errors and secure the best possible Medicare coverage."

"How the end of the COVID health emergency affects your Medicare"

May 25, 2023

"Navigating the complexities of Medicare enrollment can be overwhelming and even daunting for the millions of Americans turning 65 each year. Making a single mistake during this process can result in significant financial consequences. By understanding the timing, coverage options, plan selection criteria, enrollment methods, and the importance of annual plan reviews, you can ensure your clients avoid costly errors and secure the best possible Medicare coverage."

"Medicare for You – Diane Omdahl podcast appearance"

May 28, 2023

"Navigating the complexities of Medicare enrollment can be overwhelming and even daunting for the millions of Americans turning 65 each year. Making a single mistake during this process can result in significant financial consequences. By understanding the timing, coverage options, plan selection criteria, enrollment methods, and the importance of annual plan reviews, you can ensure your clients avoid costly errors and secure the best possible Medicare coverage."

"How the end of the COVID health emergency affects your Medicare"

May 18, 2023

"Telehealth has been extended. That is a significant change that will carry through 2024,' says Diane Omdahl, president and cofounder of 65 Incorporated.'Maybe they’ll find out the benefit of it and they’ll extend it again.'"

"$166,000 to $197,000: New estimates for retirement health care costs may be too low"

February 18, 2023

"Most Americans underestimate their health care costs in retirement, and that’s a problem because those future bills may turn out to be considerably higher than you expect... And those may be lowball estimates, experts say, underscoring the need for workers to focus either on ways to reduce those overall costs or use every tool to save up enough."

"Why Joe Namath May Be the Biggest Threat to Your Clients’ Retirement"

"The commercials are relentless. Cleverly nestled between episodes of Matlock and Golden Girls, each ad features boomer-friendly celebrities like Joe Namath, Mike Ditka and Jimmie “JJ” Walker breathlessly imploring viewers to find out if they’re missing out on “important new Medicare benefits.” And, to do so now “before it’s too late!”

"8 Things to Know When Choosing a Medicare Plan"

"The choices can be confusing, and the fine print is important. But it’s crucial to choose wisely, because it may be hard to change your mind," writes reporter, Neal Templin. This article features our co-founder and Medicare expert, Melinda A. Caughill, CSA, through out the article.

"Medicare vs. Medicaid: What Is the Difference?"

November 10, 2021

"They sound similar, but each serves different populations – though there can be some overlap," writes reporter, David Levine. This article features our co-founder and Medicare expert, Diane J. Omdahl, RN, MS.

"The Pros and Cons of Medicare Advantage"

November 22, 2022

"These popular plans may carry hidden risks. Here’s what to know," writes reporter, Penelope Wang. This article features our co-founder and Medicare expert, Melinda A. Caughill, CSA.