Assault of the Medicare Machines

Overlaying the American Health Care system means we inform some scary tales. This episode of “An Arm and a Leg” seems like an actual horror film. 

IT makes use of one in all Hollywood’s favourite tropes: machines taking on. And the machines belong to the non-public Health insurance coverage firm UnitedHealth Group. 

Host Dan Weissmann talks to Stat Information reporter Bob Herman about his investigation into Medicare Benefit plans that use an algorithm to make choices about affected person care. The algorithm is owned by a subsidiary of UnitedHealth Group.

Herman tells Weissmann that a few of UnitedHealth’s personal workers say the algorithm creates a “ethical disaster” wherein care is unfairly denied.

Scary stuff! Such reporting even has caught the attention of highly effective folks in authorities, placing Medicare Benefit plans underneath scrutiny.

Dan Weissmann


Host and producer of “An Arm and a Leg.” Beforehand, Dan was a workers reporter for Market and Chicago’s WBEZ. His work additionally seems on All Issues Thought-about, Market, the BBC, 99 % Invisible, and Reveal, from the Middle for Investigative Reporting.


Emily Pisacreta

Adam Raymonda
Audio Wizard

Ellen Weiss

Click on to open the Transcript

Transcript: Son of Medicare: Assault of the Machines

Observe: “An Arm and a Leg” makes use of speech-recognition software program to generate transcripts, which can comprise errors. Please use the transcript as a instrument however verify the corresponding audio earlier than quoting the podcast.

Dan: Hey there–

So that is sort of a horror story. However IT’s not fairly the sort of story IT would possibly sound like at first.

As a result of at first, IT would possibly sound like a horror story about machines taking on, making all the selections– and making horrible, horrifying decisions. Very age-of-Synthetic Intelligence.

However that is actually a narrative about choices made by folks. For cash.

IT’s additionally sort of a twofer sequel– like these films that pit two characters from earlier tales towards one another. Like Godzilla vs King Kong, or Alien vs Predator.

Though on this case, I’ve gotta admit, the 2 monsters should not essentially combating one another.

Let’s get reacquainted with them. 

On one facet, getting back from our final episode, we’ve obtained Medicare Benefit: That is the model of Medicare that’s run by non-public insurance coverage firms. 

IT’s obtained a vivid and interesting facet, in comparison with the standard Medicare program run by the federal authorities, as a result of: IT can price lots much less, month to month — saving folks cash on premiums. And IT usually comes with additional advantages, like dental protection, which conventional Medicare doesn’t supply. [I know.]

However Medicare Benefit can have a darkish facet, which is mainly: Properly, you find yourself coping with non-public insurance coverage firms for the remainder of your life. You want one thing — a take a look at, a process, no matter — they may resolve to not cowl IT.

Which will be scary. 

Our different returning monster — am I actually calling them a monster? — effectively, final time we talked about them, in 2023, we had an skilled calling them a behemoth. That’s United HealthGroup. You would possibly keep in mind, they’re not solely one of many largest insurance coverage firms 

— and possibly not-coincidentally the very largest supplier of Medicare Benefit plans —

they’ve additionally obtained a complete different enterprise– underneath the umbrella identify Optum. And Optum has spent the final bunch of years shopping for up a gazillion different Health Care firms of each sort. 

That features medical practices — they make use of extra medical doctors than anybody else, by an enormous margin. IT contains surgical procedure facilities, and home-Health firms, and each sort of intermediary firm you’ll be able to think about that works behind the scenes — and have their palms in an enormous share of physician payments and pharmacy visits. 

A number of years in the past, United purchased an organization referred to as NaviHealth, which supplies providers to insurance coverage firms that run Medicare Benefit plans. 

NaviHealth’s job is to resolve how lengthy somebody wants to remain in a nursing dwelling, like if you happen to’re discharged from a hospital after surgical procedure, however you’re not able to go dwelling but.

And the horror story– the tales, as dug up by reporters — begins after United purchased NaviHealth.

And based on their experiences, IT entails folks getting kicked out of these nursing houses who aren’t able to go dwelling. 

Individuals getting despatched dwelling who can’t stroll up the steps of their home. Who can’t stroll in any respect. Who’re on feeding tubes. Individuals who NaviHealth’s personal workers are saying, “Wait. This individual isn’t able to go dwelling.”

However their new bosses have advised them: You’re not likely making these choices anymore. 

That is the place machines do enter the image.

NaviHealth’s distinctive providing has at all times been its proprietary algorithm– an algorithm that makes predictions about how lengthy any given affected person would possibly want to remain. 

Earlier than United purchased the corporate, that algorithm was used as a information, a first-guess. People weighed in with their very own judgment about what sufferers wanted.

After United purchased the corporate, folks inside have advised reporters, that modified: The brand new homeowners mainly advised their workers, If the algorithm says somebody can go dwelling after x days, that’s after we’re slicing them off.

 Like just about any horror film, this story’s obtained folks operating round attempting to inform everybody: HEY, WATCH OUT! THERE’S SOMETHING BIG AND DANGEROUS HAPPENING HERE.

And on this case, they’ve truly gotten the eye of some individuals who might need the facility to do one thing about IT. Now, what these folks will do? We don’t know but. 

And, by the way in which: Sure, I stated on the finish of our final episode that we’d be speaking about Medicaid this time round. That’s coming! However for now, strap in for this one. 

That is An Arm and a Leg, a present about why Health Care prices so freaking a lot, and what we will possibly do about IT. I’m Dan Weissmann. I’m a reporter, and I like a problem. So our job on this present is to take one of the enraging, terrifying, miserable components of American life, and convey you one thing entertaining, empowering, and helpful.

So. I stated that, like each horror film, this one has people who find themselves seeing what’s occurring and try to warn everyone?

Like these films, we’re gonna observe a type of folks, watch them uncover the issue, see how deep IT goes, and begin ringing alarm bells. Let’s meet our man.

Bob Herman: My identify is Bob Herman. I’m a reporter at STAT Information

Dan: Stat is an incredible medical information publication. Bob covers the enterprise of drugs there. Bob began engaged on this story in November 2022, after speaking to a supply who runs nursing houses. Bob’s supply was complaining about Medicare Benefit. 

Bob Herman: There have been plenty of cost denials. They simply weren’t in a position to receives a commission. And simply offhandedly, the supply talked about like, um, you already know, they usually’re attributing all the pieces to this algorithm. This algorithm stated, You realize, solely 17 days for our sufferers after which time’s up and I went operating to Casey Ross 

Dan: Casey is a reporter at Stat who focuses on tech and AI in healthcare. Bob stated, hey, what do you consider this? Wanna crew up?

Bob Herman: And he was hooked.

Dan: They began speaking to individuals who labored at nursing houses, speaking to specialists, and speaking to households. And IT was clear: They have been onto one thing. 

Bob Herman: IT took so many households unexpectedly to be like, what do you imply we’re going dwelling? The, you already know, my husband, my spouse, my grandma, my grandpa, they’ll’t go to the toilet on their very own. Like, what do you? IT was simply, IT was so complicated to folks. IT appeared like such a, a chilly calculation,

Dan: One individual they ended up speaking with was Gloria Bent. Her husband Gary was despatched to a nursing dwelling for rehab after mind surgical procedure for most cancers. He was weak. He couldn’t stroll. And he had one thing referred to as “left neglect”: His mind didn’t register that there was a left facet of his physique. Right here’s Gloria testifying earlier than a Senate committee about how — when Gary arrived on the nursing dwelling — the very first thing he obtained was a discharge date. That’s…

Gloria Bent: Earlier than the workers of the power might even consider my husband or develop a plan of care, I used to be contacted by somebody who recognized themselves as my Navi Health Care Coordinator

Dan: Gloria says when she advised the nursing dwelling workers she’d heard from NaviHealth, they groaned. And advised her what to anticipate. 

Gloria Bent: I used to be advised that I had simply entered a battlefield, that I might anticipate a sequence of notices of denial of Medicare cost accompanied by a discharge date that might be two days after I obtained that discover.

Dan: Yeah, they stated she’d get two days discover. Gloria says the nursing dwelling workers advised her she’d have 24 hours to enchantment every of these, however even when she gained, the denials would hold coming. The truth is, they stated,

Gloria Bent: If we gained a few appeals, then we might anticipate that the frequency with which these denials have been going to return would improve.

Dan: All of which occurred. NaviHealth began issuing denials July 15, 2022, after Gary had been on the dwelling for a month.

Gloria appealed. She advised senators what the physician who evaluated the enchantment discovered: Gary couldn’t  stroll. He couldn’t even transfer — like from mattress to a chair — with out assist from two folks.. That reviewer took Gloria’s facet.

Her husband’s subsequent denial got here every week after the primary. Gloria gained that enchantment too. She says the reviewer famous that Gary wanted most help with actions of each day residing. 

The third denial got here 4 days later, and this time Gloria misplaced. 

Gary got here dwelling in an ambulance: As Gloria testified, he couldn’t get into or out of a automotive with out help from somebody with particular coaching. 

And when he obtained into the ambulance, he had a fever. The following morning, he wound up in one other ambulance — headed to a hospital with meningitis. He misplaced plenty of the functioning he’d picked up on the nursing dwelling. 

He died at dwelling just a few months later. When Gloria testified within the Senate, all of IT was nonetheless contemporary. She advised them that as terrible as Gary’s sickness and decline had been, the fights with insurance coverage have been an added trauma.

Gloria Bent: This shouldn’t be occurring to households and sufferers. IT’s merciless. Our household continues to wrestle with the query that I hear you asking immediately. Why are people who find themselves taking a look at sufferers solely on paper or by means of the lens of an algorithm

making choices that deny the providers judged essential by Health Care suppliers who know their sufferers.

Dan: Bob Herman calls Gloria’s story heartbreaking, like so many others he’s seen. 

And his consideration goes to at least one a part of Gloria’s story past denial-by-algorithm. 

As a result of: IT’s not only one denial. IT’s that sequence of denials. You possibly can enchantment, however as Gloria testified, the denials velocity up. And you need to win each single time. The corporate solely has to win as soon as. 

I imply, except you’re able to get a lawyer and take your probabilities in courtroom– which, along with being a significant endeavor, additionally means racking up nursing dwelling payments and authorized payments you might by no means get reimbursed for, whereas the courtroom course of performs out. 

Bob Herman: This enchantment system is designed in such a means that individuals will surrender. When you’ve got a job, you already know, even if you happen to don’t, and also you’re, and also you’re additionally attempting to maintain a member of the family, um, IT’s a rigorous monotonous course of that may chew folks up and spit them out after which the individuals are inevitably going to surrender. And I believe in some methods insurers know that.

Dan: Going out on a limb to say: I believe so too. So Bob and Casey’s first story on NaviHealth got here out in March of 2023. They have been the characters within the film who go, “HEY, I THINK THERE’S SOMETHING REALLY BAD HAPPENING HERE.”

And other people began paying consideration. Just like the U.S. Senate. which held that listening to the place Gloria Bent advised her story. 

And just like the federal company that runs Medicare — the Facilities for Medicare and Medicaid Companies, CMS. 

CMS finalized a rule that advised insurers: You possibly can’t deny care to folks simply from utilizing an algorithm. 

And one thing else occurred too: Bob and Casey began all of the sudden getting lots MORE Information

Bob Herman: We obtained so many responses from folks and IT simply opened the floodgates for former workers, simply sufferers and relations, simply everybody throughout the board.

Dan: And never simply former workers. Present workers. And what they realized was: There was completely a method at work in how this algorithm was getting used. IT was technique some folks on the within didn’t be ok with. 

And this technique obtained developed after United HealthGroup — and its subsidiary, Optum– purchased NaviHealth in 2020. And right here’s what NaviHealth workers began telling Casey and Bob about that technique.

Bob Herman: For a few of us, IT’s creating this ethical disaster. Like we all know that we’re having to hearken to an algorithm to basically kick somebody out of a nursing dwelling, regardless that we all know that they’ll barely stroll 20 toes.

Dan: What Bob and Casey realized from insiders– and the way IT connects to United’s function as a Health Care behemoth– that’s subsequent.

This episode of An Arm and a Leg is produced in partnership with KFF Health Information. That’s a nonprofit newsroom protecting healthcare in America. Their reporters do wonderful work, and I’m honored to work with them. We’ll have slightly extra about KFF Health Information on the finish of this episode.

So, NaviHealth — the corporate with the algorithm — obtained began in 2015.. And the thought behind IT was to make use of information to get folks dwelling sooner from nursing houses in the event that they didn’t truly must be there. 

As a result of there was plenty of proof that some folks have been being stored longer than they wanted. 

Bob Herman: There’s some validity to the concept there’s, there’s wasteful care in Medicare, like, you already know, there’s been circumstances previously proving that individuals keep in a nursing dwelling for means longer than is critical. And clearly there’s monetary incentives for nursing houses to maintain folks so long as potential. 

Dan: Conventional Medicare does have limits on nursing dwelling care — however if you happen to want “post-acute care” — assist getting again in your toes after leaving a hospital conventional Medicare pays in full for 20 days– just about no questions requested. One of many promoting factors of Medicare Benefit — like promoting factors to coverage nerds and politicians — was that IT might reduce waste, by asking these sorts of questions. NaviHealth and its algorithm have been designed to assist Medicare Benefit plans ask these questions in a wise means. 

Bob Herman: There have been… plenty of believers inside NaviHealth that have been like, okay, I believe we’re doing the correct factor. We’re attempting to ensure folks get dwelling sooner as a result of who doesn’t need to be at dwelling.  

Dan: And as these workers advised Bob and Casey: Earlier than United and Optum got here in, the algorithm had been there as a information — a sort of first guess — however not the ultimate phrase. 

NaviHealth has workers individuals who work together instantly with sufferers. And again within the day, the pre-United day, Bob and Casey realized that these workers might make their very own judgments. 

Which made sense, as a result of the algorithm doesn’t know all the pieces about any particular person case. IT’s simply making predictions based mostly on the information IT has.

Bob Herman: And there was simply, simply this noticeable change after United and OptiMentor that IT felt extra inflexible. There’s no extra variation. 

Dan: If the algorithm says you go, you’re just about going.

Bob Herman: United has stated, no, that’s not the case, however clearly these paperwork and different communications that we’ve gotten sort of say in any other case.

Dan: As a result of these workers weren’t simply speaking. They have been sharing. Inner memos. Emails. Coaching supplies. All making clear: The corporate wished folks shipped out on the algorithm’s timetable. 

Bob Herman: Paperwork got here in displaying that like this was a reasonably express technique. You realize, UnitedHealth was telling its workers. Hear, now we have this algorithm. We predict IT’s actually good. So when IT tells you what number of, what number of days somebody ought to be in a nursing dwelling, follow IT.

Dan: Stick with IT or possibly be fired. Bob and Casey obtained paperwork — worker efficiency objectives– saying: How shut you follow the algorithm’s suggestions? That’s a part of how we’re evaluating your job efficiency. 

Bob Herman: IT’s okay. Algorithm stated 17 days, you higher not likely go exterior of that as a result of your job is on the road. 

Dan: Right here’s how carefully folks have been anticipated to stay to IT. In 2022, worker efficiency objectives shared with STAT confirmed that staff have been anticipated to maintain precise time in nursing houses to inside three p.c of what the algorithm stated IT ought to be. Throughout the board.

So, say you had 10 sufferers, and the algorithm stated they every ought to get 10 days. That’s 100 days. Your job was to be sure that the whole precise days for these sufferers didn’t go previous 103 days.

Then, in 2023, the expectations obtained extra stringent: Keep inside one p.c of the algorithm’s predictions. 10 sufferers, the algorithm says 100 days whole? Don’t let IT get previous 100 and one. 

Bob Herman: Like that’s, nearly nothing. Like what, what, your palms are tied. In the event you’re that worker, what are you going to do? Are you going to get fired? Are you going to do what you’re advised?

Dan: And one one who ended up speaking, to did get fired. 

Bob Herman: Right. Sure. Uh, Amber Lynch did get fired And what she stated was what we had additionally heard simply extra broadly was IT, IT created this inner battle, like, Oh my God, what I’m doing doesn’t really feel proper. 

Dan: Amber Lynch was a case supervisor. She advised Bob and Casey about onepatient who couldn’t climb the steps in his dwelling after knee surgical procedure. However the algorithm stated he was prepared. Amber’s supervisor stated, “Have you ever requested the nursing dwelling workers in the event that they’ve tried to show him butt bumping?” Amber grit her enamel and made the suggestion to the rehab director.

Amber Lynch: And she or he checked out me like I had two heads. She’s like, he’s 78 years outdated. He’s not going to try this. He’s not secure to climb the steps but. He’s not doing IT. We’re not going to have IT butt bump the steps.

Dan: Amber advised Bob and Casey that when she obtained fired, IT was partly for failing to hit the one p.c goal and partly for being late with paperwork– which she advised Bob and Casey she fell behind as a result of her caseload was so heavy.

She wasn’t the one one with that grievance. 

Bob and Casey’s story reveals one other NaviHealth case supervisor– not named within the story as a result of they’re nonetheless on the job — of their dwelling workplace, struggling to maintain up. 

That week, they have been imagined to work with 27 sufferers and their households. Collect paperwork, maintain conferences. One other week, shortly earlier than, they’d had 40 sufferers. 

“Do you suppose I used to be in a position to course of all the pieces appropriately and name everybody appropriately the way in which I used to be imagined to?” the case supervisor requested. “No. IT’s unattainable. Nobody will be that quick and that efficient and seize all the Information that’s wanted.”

Bob and Casey watched this case supervisor fill out a digital kind, feeding the algorithm the Information IT requested for on a person in his 80s with coronary heart failure, kidney illness, diabetes and bother swallowing, who was recovering from a damaged shoulder. 

A couple of minutes later, the pc spat out a quantity: 17 days. 

The case supervisor didn’t have plenty of time or leeway to argue, however they have been skeptical that the algorithm might get that quantity precisely proper based mostly on solely the information IT had. 

And what information is the algorithm working with? What’s IT evaluating the information on any given affected person TO? Bob Herman says that’s a giant query.

Bob Herman: IT’s one thing that for certain, like Casey and I, IT’s been bothering us. Like, what, how is that this complete system? Like, what’s IT based mostly on? And we have been by no means actually given straight solutions on that. NaviHealth and Optum and United have stated IT’s based mostly on hundreds of thousands of affected person information over time. The sources of that, IT’s, IT’s slightly unclear, the place all that’s coming from. 

Dan: Bob and Casey talked with an skilled named Ziad Obermeyer, a professor on the College of California Berkeley Faculty of Public Health, who isn’t anti-algorithm. He truly builds algorithmic instruments for determination making in public Health

AND he’s completed analysis displaying that some widely-used algorithms simply scale up and automate issues like racial bias.

He advised Bob and Casey: Utilizing an algorithm based mostly on how lengthy different, earlier sufferers have stayed in a nursing dwelling — that’s not an ideal concept.

As a result of folks get compelled out of nursing houses, in his phrases, “as a result of they’ll’t pay or as a result of their insurance coverage sucks.” He stated, “So the algorightm is mainly studying all of the inequalities of our present system.”

And leaving apart that sort of bias, IT appears unlikely to Bob that any algorithm might predict precisely what each single affected person will want each single time. 

Regardless of how a lot information IT’s obtained, IT’s predicting from averages.

Bob Herman: IT jogs my memory of, like, a basketball sport the place let’s say somebody averages 27 factors per sport. They don’t have 27 factors each single, the sport they go on the market. IT simply varies every now and then.

Dan: However the NaviHealth algorithm doesn’t should be proper each time for United to generate income utilizing IT

Utilizing IT to make choices can permit United to spice up earnings coming and going.

Bob Herman: United Health and the opposite insurance coverage firms that use Navi Health. Are utilizing this Technology to kind of kick folks out of nursing houses earlier than they’re prepared. And that’s the claims denial facet the place IT’s like, okay, let’s save as a lot cash as we will as an alternative of getting to pay IT to a nursing dwelling.

Dan: And that’s only one facet of IT. The insurance coverage facet. Claims denial. However United isn’t simply within the insurance coverage enterprise. 

United’s Optum facet is in each different a part of Health Care

Together with — within the years since United took over NaviHealth — dwelling Health providers. The sort of providers you’re prone to want if you depart a nursing dwelling.

In 2022, Optum purchased one high dwelling Health firm in what one commerce publication referred to as a “monster, jaw-dropping mega-deal” — greater than 5 billion {dollars}. In 2023, Optum made a deal to purchase a second mega-provider. 

Bob and Casey’s story says NaviHealth’s shortening nursing dwelling stays is integral to United’s technique for these acquisitions. IT does appear to open up new alternatives.

Bob Herman: You’re out of the nursing dwelling as a result of our algorithm stated so. Now we’re going to ship you to a house Health company or we’re going to ship some dwelling Health aides into your house. And by the way in which, we personal them. 

Dan: Oh, proper, as a result of: In the event you’re in a Medicare Benefit plan, your insurer can let you know which suppliers are lined. 

Bob Herman: So the true query turns into, how a lot is United doubtlessly paying itself?

Dan: That’s: How a lot would possibly United find yourself taking cash out of 1 pocket — the Health insurance coverage facet — and paying itself into one other pocket, Optum’s home-Health providers?

We don’t know the reply to how a lot United is paying itself on this means, or hoping to. And United has stated its insurance coverage arm doesn’t favor its in-house companies.

However IT looks as if an inexpensive query to ask. Really, IT’s a query the feds appear to be asking.

Optum hasn’t wrapped up its buy of that second home-Health firm but, and in February 2024, the Wall Avenue Journal and different retailers reported that the U.S. Division of Justice had opened an anti-trust investigation. 

And also you don’t should be in a Medicare Benefit plan run by United to get kicked out of a nursing dwelling on an algorithm’s say-so. 

Bob Herman says NaviHealth sells its algorithm-driven providers to different large insurance coverage firms 

He says, put collectively, the businesses that use NaviHealth cowl as many as  15 million folks — about half of everyone in Medicare Benefit.

Bob Herman: Odds are, if you happen to’re in a Medicare Benefit plan, there’s a, there’s a extremely good shot that your protection insurance policies, if you happen to get actually sick and wish nursing dwelling care, for instance, or any sort of publish acute care, an algorithm could possibly be at play sooner or later.

Dan: That is the darkish facet of Medicare Benefit. 

Bob Herman: Everybody loves their Medicare Benefit plan after they first join, proper? As a result of IT’s providing all these bells and whistles. IT’s, right here’s a gymnasium membership. IT’s obtained dental and imaginative and prescient, which common Medicare doesn’t have. And IT’s additionally simply, IT’s, IT’s cheaper. Like, if IT’s simply from a monetary standpoint, if, if you happen to’re a low earnings senior, How do you flip IT down? There’s, there’s so many plans that provide like free, there’s no month-to-month premiums along with all of the bells and whistles. However No one understands the commerce offs , Once you’re signing up for Medicare and Medicare Benefit, you’re on the more healthy facet of, of being a senior, proper?

Dan: And none of us can rely on staying wholesome eternally. Once you join Medicare  you’re signing up your future self — whether or not that’s ten or twenty or extra years out. That future you, would possibly actually need good medical care. 

And at that time, as we defined in our final episode, if Medicare Benefit isn’t working for you, you might not be capable of get out of IT.

Bob Herman: You possibly can doubtlessly not totally get the care that you simply want. We shouldn’t assume that, that this couldn’t occur to us as a result of IT can. 

Dan: So, yeah. Sort of a horror story. However: Not like some horror films, when Bob and Casey began publishing their tales, they began getting folks’s consideration.

We talked about the brand new guidelines from the feds and the senate hearings after Bob and Casey’s first story in March 2023

Later within the yr, when Bob and Casey revealed their story with paperwork and tales from inside NaviHealth, a class-action lawsuit obtained filed.

Since then, CMS has stated IT will step up audits underneath its new guidelines. 

Bob Herman: There was a memo that CMS despatched out to Medicare benefit plans that stated, Hey, hear, we’re telling you once more, don’t deny care solely on any AI or algorithms. Like simply don’t do IT

Dan: And in February 2024, the Senate held one other listening to. 

Right here’s Senator Elizabeth Warren at that listening to, saying these CMS guidelines aren’t sufficient. We’d like stronger guardrails.

Elizabeth Warren: Till CMS can confirm that AI algorithms reliably adhere to Medicare protection requirements by regulation, then my view on that is CMS ought to prohibit insurance coverage firms from utilizing them of their MA plans for protection choices. They’ve obtained to show they work earlier than they put them in place.

Dan: So folks — folks with not less than some energy– are paying some consideration. 

Bob Herman: I don’t suppose that is essentially going to flee. Political scrutiny for some time. 

Dan: So, mainly, the story isn’t over. 

This isn’t a type of horror films the place the monster’s been safely defeated on the finish, and everyone simply begins cleansing up the mess. And IT’s not one the place the monster is simply on the free, unleashing the apocalypse. 

As a result of IT’s not a film. There’s no ending. There’s simply all of us attempting to determine what’s occurring, and what we will possibly do about IT.

One final thing: I obtained plenty of emails after our final episode, the place we laid out plenty of Information about Medicare Benefit and conventional Medicare. Most of IT was alongside the strains of, Thanks! That was actually useful! Which made me really feel actually good.

And we obtained a pair notes about issues we might have completed higher. Particularly this: We stated Conventional Medicare leaves you on the hook for 20 p.c of all the pieces, with out an out of pocket restrict. 

Which is true — however just for Medicare Half B: Physician visits, outpatient surgical procedures and exams. Which may add up, for certain.

Medicare Half A — if you happen to’re truly hospitalized — covers most providers at one hundred pc, after you meet the deductible. In 2024 that’s one thousand, 600 thirty-two {dollars}. 

Due to Clarke Lancina for pointing that out. 

There have been a bunch of different, wonderful notes in my inbox not too long ago, and I need to say: Please hold them coming. 

In the event you go to arm and a leg present dot com, slash, contact, no matter you kind there goes straight to my inbox. You possibly can connect stuff too: paperwork… voice memos. 

Please let me hear from you. That’s arm and a leg present dot com, slash contact.

I’ll catch you in just a few weeks. 

Until then, maintain your self.

This episode of an arm and a leg was produced by me, Dan Weissmann, with assist from Emily Pisacreta, and edited by Ellen Weiss. 

Adam Raymonda is our audio wizard. Our music is by Dave Weiner and blue dot periods. Additional music on this episode from Epidemic Sound.

Gabrielle Healy is our managing editor for viewers. She edits the primary help package publication. 

Bea Bosco is our consulting director of operations. Sarah Ballama is our operations supervisor. 

And Arm and a Leg is produced in partnership with KFF Health Information. That’s a nationwide newsroom producing in depth journalism about healthcare in America and a core program at KFF, an unbiased supply of Health coverage analysis, polling and journalism. 

Zach Dyer is senior audio producer at KFF Health Information. He’s editorial liaison to this present. 

And because of the Institute for Nonprofit Information for serving as our fiscal sponsor, permitting us to just accept tax exempt donations. You possibly can be taught extra about INN at INN. org. 

Lastly, due to everyone who helps this present financially– you’ll be able to take part any time at arm and a leg present dot com, slash, help — and thanks for listening.

“An Arm and a Leg” is a co-production of KFF Health Information and Public Street Productions.

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