For Beth Swenson, the mere volume of Medicare information available was daunting, especially because she didn’t know where to start.
The complexity of Medicare insurance choices is often confusing for most Americans, said Swenson, an Ames resident and a board of trustees member at Mary Greeley Medical Center (MGMC).
“I really don’t like grappling with this annually,” Swenson said. “But I have no choice but to do it.”
Oct. 15 to Dec. 7 is the annual Medicare enrollment period, when 69 million-eligible Americans choose Medicare Part B, Part C, and Part D plans to cover them for their health care each year. Every Iowan eligible for Medicare receives a 131-page paper handbook each year, outlining information about the various benefits, rights and choices to enroll in the multiple parts of Medicare.
“I was overwhelmed by all the Medicare information available online for options,” Swenson said.
Swenson asked for help in choosing her plans when she retired at age 62. Swenson used a medical advisory company because “they were able to explain to me my options and helped me to figure out which plan was right for me.”
Where to get help
Using Medicare.gov can be a good starting point. For Swenson, she uses the website to continue with her Medicare supplemental plan choices — which has also been “a great help” for finding drug and dental insurance renewals.
Seniors Health Insurance Information Program (SHIIP): SHIIP is a state program funded by the federal government to provide free in-person and online individualized advice from volunteer counselors who are very knowledgeable about Medicare choices, says Swenson.
Swenson, a former laboratory technician at MGMC, says she “heard great things” about SHIIP.
Iowa SHIIP counseling started in 1990 by the Iowa Insurance Division, one of the first states to offer unbiased information about the complex Medicare choices. More than 40,000 Medicare beneficiaries are served annually in Iowa by SHIIP counselors.
Individual Counseling: Joan Grabenstetter, a retired obstetrician-gynecologist at McFarland Clinic, has been a SHIIP counselor for nine years. She became interested in Medicare counseling after learning about SHIIP in a program at MGMC, and she became “enthused about informing” retirees and helping them find an affordable plan to cover what’s needed.
“We also screen for eligibility for assistance with medical costs and help people apply,” she said.
Grabenstetter highly encourages using SHIIP and its wealth of information plus “Welcome to Medicare” seminars — online or in-person — and getting written information to study three to six months before retirement to help prepare.
“Don’t underestimate how complicated Medicare and associated insurance is,” she said.
Insurance Brokers: About one third of Medicare beneficiaries use insurance brokers, who receive commissions from insurers for new enrollees and for renewal of enrollees. About half of these customers choose Medicare Advantage plans, and the other half choose Medicare supplemental (Medigap) plans.
Richard Roepke, who moved to Ames after he retired, said the choice of various Medicare plans is very complex.
“Unfortunately, this process is confusing to a lot of people despite the availability of information,” he said. “Don’t be afraid to talk to knowledgeable people and reliable senior sources. Be aware of sign-up dates and deadlines, know the rules and stay informed.”
There are many local and online licensed health insurance brokers to choose from, including Tucker Mitchell, a licensed health insurance broker with American Republic Insurance, who offers help with health insurance year-round.
“There is confusion, because many people get stuff in the mail and phone calls offering various deals,” Mitchell said. “Often people do not know who to trust.”
Find someone to trust: Roepke suggests retirees “read up on Medicare and Social Security issues and stay informed.”
“I would advise folks not to answer all the random phone calls that are selling insurance products,” he said. “Talk to your personal insurance agent and good friends that are knowledgeable and have been through the process.”
Grabenstetter said it is best not to answer calls from unknown numbers this time of year.
“Talking to scammers generates more unwanted calls, and they are very skilled at convincing us to believe their story, but as soon as someone asks for personal information, end the call,” she said. “If you’re being offered free stuff from Medicare, it’s a scam and yes, there is some deceptive advertising out there. Also always report scams to SHIIP or 1-800-MEDICARE, and if your Medicare number is lost or stolen, you will be issued a new number to protect Medicare funds.”
Shortage of SHIIP counselors
The Medicare information sites also include invitations to become a volunteer SHIIP counselor, because there’s great need for these trained experts. Though there are six SHIIP counselors at MGMC and two counselors at Story Medical in Nevada, because of the demand, appointments have all been taken until after the Dec. 7 enrollment deadline.
Grabenstetter also warns, “People should only work with an agent they know and trust. There are many scams this time of year, bogus agents who sign people up for plans they don’t want or need, so it’s necessary to be skeptical and check credentials.”
The four parts of Medicare
One easy way for new Medicare beneficiaries to learn about the parts of Medicare is to watch a free webinar available at the McFarland Clinic website. The webinar is presented by Judy Brannon, a SHIIP advocate whose “passion for simplifying Medicare makes her the perfect guide to help you make Medicare easier to understand.”
Part A (Hospital): This part covers inpatient hospital services and should be signed up for within three months of one’s 65th birthday — before or after. It is usually premium-free if the retiree has paid Medicare taxes while employed, and enrollment is one time only, not yearly.
Part B (Medical): Part B Medicare is optional and is not free. It covers almost all medical services such as doctors’ care and hospital outpatient services and preventive care, but it pays only 80% as there is a 20% co-pay for each service. The “original” Medicare Part B has monthly premiums starting at $185 in 2025, but premiums are higher for people with higher incomes, and Part B premiums can increase each year. Low-income Americans may have Medicaid and no premiums if their income is under the poverty level. Part B’s original Medicare plan has no out-of-pocket limit, unless there is other coverage such as Medigap — also called supplemental Medicare insurance.
Since not everyone wanted to be at risk of paying 20% co-pays for all their Part B services, or not having an out-of-pocket limit of the Part B co-pays, Supplemental Part B (Medigap) plans have been offered since 1966 for “original” Medicare — and are administered by private insurers and have numerous variations. These private supplemental insurance plans are all connected to what is called “original” or “traditional” Part B Medicare, to differentiate them from Medicare Advantage (Part C) plans which started in 1997.
Part C (Medicare Advantage): An optional choice for original Part B and Medigap supplemental insurance is Medicare Part C, called Medicare Advantage (MA), administered only by private insurers, also with numerous variations. Not all hospitals and doctors have contracts with Medicare Advantage plans. For example, for 2026, Mayo Clinic has dropped most contracts with MA plans, and MGMC has also dropped one plan (Aetna’s MA plan). Most hospitals and doctors accept all supplemental (Medigap) plans.
MA plans (not Medicare original) now cover about 55% of all Medicare beneficiaries, and 42% of the patients on original Medicare plans choose supplemental (Medigap) plans. The rest, who have original Medicare and are without a supplemental plan would pay all the 20% co-pays and have no out-of-pocket cost limit for Part B.
The various choices of Part B’s “original” Medicare supplemental plans, and the options of many Part C MA plans – and hospitals and doctors that may not accept all MA plans – are what make this coverage area so complex.
Part D (Prescription): Part D Medicare Drug plans are all private insurance plans which also vary in many ways, making Medicare choices even more difficult.
People who cover their health with MA plans (Part C) have drug, dental, hearing and vision care covered to some extent. Original Medicare plan B and supplemental Medigap plans do not cover dental care, vision care, and hearing aids. Most original Medicare beneficiaries therefore often buy dental and occasionally vision care insurance.
Finding out which hospitals and doctors do or don’t accept many MA plans can be a problem and frustrating even for brokers and counselors. People who travel around the country are covered by their MA plans for emergencies even if the hospital doesn’t accept their MA plan for anything else, but many frequent travelers avoid MA plans.
Go to the medicare.gov and shiip.iowa.gov websites for more information to help make the best choice for you.
