What You Need to Know About Medicare Advantage and Home-Based Care

Medicare enrollment and coverage changes are crucial topics every American should understand, especially when it comes to Medicare Advantage. In this episode of Who Cares, hosts Elyssa Katz and Dr. Steve Landers break down the complexities of Medicare enrollment and Medicare Advantage plans with humor, honesty, and clarity. The conversation tackles how coverage may vary based on location, plan design, and health needs, and why you should read the fine print to know what’s best for you.

With over 31 million Americans enrolled in Medicare Advantage plans, understanding how they differ from Traditional Medicare has never been more important. Dr. Landers shares firsthand insights from the frontlines of healthcare, where patients may be caught off guard by the differences between the plans.

Elyssa and Dr. Landers also tackle the role of policy in perpetuating or alleviating these problems. They call on healthcare professionals, caregivers, and advocates to help bridge the education gap so people can make informed choices. But the episode doesn’t just stay in the policy weeds. There are plenty of human moments too, stories of patients who had to drive 80 miles just to find a specialist, or who were left paying out-of-pocket for care they thought was covered. It’s critical information for anyone approaching 65 or supporting a loved one who is.

By the end of the episode, listeners will walk away with a clear understanding of:

How Medicare Advantage originated
The difference between Traditional Medicare and Medicare Advantage
What to understand before choosing a plan
How the policy landscape is shaping patient outcomes

It’s not just an episode, it’s a must-listen primer on one of healthcare’s most complex topics.

00:00 – What is Medicare Advantage and why it matters
00:35 – Key differences: Medicare Advantage vs Traditional Medicare
01:20 – The history of Medicare and rise of managed care
03:00 – Challenges of fee-for-service models
04:30 – Why Medicare Advantage was introduced
07:10 – The birth of Medicare Part C (Medicare Advantage)
08:30 – Why Medicare Advantage gained popularity
11:15 – CMS vs private insurers: How MA plans operate
12:20 – Why would someone choose Traditional Medicare?
13:00 – Provider network limitations with MA
15:10 – Impact of Medicare Advantage on home-based care
16:00 – Hospice vs MA: Managed differently by design
19:00 – Where the MA + home health partnership is falling short
21:00 – Real-world frustration with MA plan requirements
24:00 – The need to reduce staff burden and admin costs
29:00 – Hospice: Why it’s a model that works
32:00 – Medicare Advantage can still support great palliative care
35:10 – What the Alliance is advocating for in MA + home care
36:00 – Final takeaway: Keep hospice out, make home health better