Send us Fan Mail

Guaranteed Issue Rights Denied: Protecting Seniors When Medicare Plans Are Non-Renewed or Terminated

Mike Roth interviews Bill Kadereit about Guaranteed Issue Rights (GIR) being denied when Medicare Advantage, Medigap, or Part D plans are non-renewed, terminated, or become unavailable after a move to another state. Kadereit explains key differences between non-renewal and termination and describes how insurers often “crosswalk” members into new plans without providing required GIR notices, limiting seniors’ ability to shop. He cites large-scale disruptions, including millions affected by 2025 terminations and non-renewals, and a Blue Cross Blue Shield of Michigan example, arguing seniors with chronic conditions can face rejection or higher costs without GIR protections. The discussion highlights weak enforcement, confusion between state and CMS responsibility, criminal/civil penalties that are not applied, and NRLN’s efforts through white papers, CMS meetings, and plans to involve attorneys general while urging seniors to report missing or inadequate notices.

00:00 Welcome and Topic

00:18 GIR Basics Explained

01:05 Nonrenewal vs Termination

01:43 Moving States Eligibility

03:06 Crosswalking Trap

04:35 Scale of the Problem

07:09 Join and Report Cancellations

09:20 Why Costs Are Rising

10:37 Penalties and No Enforcement

11:59 Who Enforces the Rules

13:26 SEP and Golden Ticket Rights

17:20 Company Plan Terminations

20:07 ACA Gap and Trial Rights

21:39 NRLN Actions and Next Steps

24:09 Wrap Up and Closing

Send us Fan Mail

2026 Medicare Enrollment: Preparing for Medicare A, B, D, Medigap vs. Advantage, and Key Deadlines

Mike Roth discusses preparing for Medicare enrollment ahead of turning 65, explaining the seven-month Initial Enrollment Period and how waiting can delay coverage. He outlines Medicare Part B (physician/clinic care, preventive services, diagnostics, and certain clinic-administered drugs), its typical monthly premium and cost-sharing, and Medicare Part A (inpatient hospital, limited skilled nursing/rehab rules, and hospice), including key hospital cost amounts and the importance of qualifying inpatient status. The episode reviews Part D prescription coverage, late-enrollment penalties, and the drug cost cap. It compares Original Medicare plus Medigap versus Medicare Advantage (Part C), highlighting subsidies, extra perks, out-of-pocket maximums, network limits, travel and provider acceptance issues, and potential denials/delays for imaging and care. Resources include Medicare.gov Plan Finder, the “Medicare & You” handbook, Social Security, and SHIP counselors, plus key enrollment dates and cautions about switching and guaranteed-issue rights.

00:00 Medicare Enrollment Prep

01:24 Part B Basics and Costs

03:15 Part A Hospital Coverage

05:08 Part D Drug Plans

05:53 Medicare Advantage Explained

08:45 Advantage vs Original Medicare

11:21 Networks and Denials

13:38 CMS Wiser and AI

15:00 Extra Perks and Tradeoffs

17:16 Getting Help and Plan Finder

21:07 Enrollment Dates and Switching

24:17 Wrap Up and Contact Info

Send us Fan Mail

Is Social Security at Risk? History, Solvency Timeline, and Policy Options

In episode two of “Creating a Better Life for Seniors,” Mike Roth and Bill Kadereit discuss whether Social Security is at risk, reviewing its origins in 1935, later additions including Medicare/Medicaid in 1965, and major changes such as the 1983 increase of full retirement age from 65 to 67. They link today’s funding challenge to slowing U.S. population growth, lower fertility/immigration, and a rising over-65 population, along with a declining worker-to-beneficiary ratio (from 5:1 in 1960 to 2.9:1 today). Citing trustee projections, they say the Old-Age and Survivors Trust can pay full benefits until late 2032, after which benefits may be reduced about 22% without action. They outline causes including boomers’ retirement, tax and benefit law changes in 2025, inequality under the $184,500 payroll cap, and discuss options: raising retirement age, increasing payroll taxes, eliminating/raising the wage cap, and means testing; they oppose raising the age and support eliminating the wage cap.

00:00 Podcast kickoff
00:36 Social Security origins
01:45 Funding can kicked
02:17 Population growth slowdown
03:39 Aging boomers pressure
05:00 Trust fund cliff 2032
07:07 Why insolvency happens
09:55 Congress options to fix
10:53 NRLN policy positions
13:12 Wrap up and next episode