27 September 2023
For more than a million Minnesotan seniors, the ads all promise health care, but the reality is that too many insurance plans end up delivering only sick care.
Oct. 15 to Dec. 7 is the open enrollment period for consumers to select a Medicare or Medicare Advantage plan. This means it’s time for the annual avalanche of TV commercials, emails and mailed brochures to try to persuade one of every five Minnesotans to switch medical coverage.
In recent years Minnesotans have moved significantly toward plans managed by private insurers, with 635,000 opting for Medicare Advantage and 470,000 picking traditional Medicare.
As a son, nurse and CEO of a local complete senior health company, I view the Medicare enrollment process three ways.
The son in me wants care that is safe, dependable and affordable for my mom and dad. I want them to age magnificently, with joy and fulfillment — and on their own terms.
The nurse in me wants care that comes with compassion and empathy. My clinical work has convinced me that a focus on wellness and prevention — and lifestyle issues like diet, exercise, friendships and life purpose — can yield vast improvements in health and happiness that sometimes exceed anything that can be done in a doctor’s office.
And the CEO in me wants to cut the bureaucracy, waste, delays and paperwork that have for too long plagued the medical business. I think we greatly improve the delivery of care when the economic incentives for medical providers are changed so that we are rewarded for keeping people healthy, not by submitting them to more tests and office visits and drugs and procedures.
The problem is, too much of the medical care coverage now being sold to Minnesota seniors is the opposite of what I want as a son, nurse and chief executive. It’s the medical equivalent of firefighting — reacting to a crisis instead of preventing it.
Too many medical providers get involved only after people are sick.
They should be offering help when people are healthy and want to stay that way.
Aging magnificently is more than using your health plan to process medical claims — it’s a partnership with more listening than lecturing, an acknowledgment that not everyone wants to grow old the same way, a promise that humble humanity can carry far more meaning than hospital hubris.
Minnesotans should demand more from their health plans and question the status quo.
Does your plan offer access to senior savvy services like 24-7-365 phone advice from nurses? House calls for in-home help when you are sick or recovering from surgery? How about telemedicine, including for mental health, that allows you to meet via video with a doctor or nurse or counselor from your home? Support setting up a wellness plan for losing weight, or stopping smoking, or ending loneliness, or drug or alcohol dependency? Often overlooked are family caregivers — does your plan offer support for them, too?
What does it take for your plan to connect you with a geriatrician — a doctor who is an expert in the medicine of aging? So many seniors rely on multiple specialists to provide treatment for different maladies. A geriatrician is the one pro who can help you coordinate the care and provide a long-term roadmap.
Will your plan cut confusion by offering a single point of contact for advice and coordination and scheduling? Why not?
If you are one of the tens of thousands of Minnesota snowbirds who winter someplace warmer — does your coverage extend to other states?
The key here is for seniors to look beyond the vision, dental and prescription benefits provided by the typical plan. Price is obviously important, but so, too, are the included services that will save you money by advancing good health.
Be bold about growing old, but also about getting what you want.
This is your annual chance to reevaluate your medical coverage, but it should be about more than just comparison shopping for an insurance plan. It also should be the time to take a moment and consider: How do you want to age? What are your hopes and dreams? And who will help you age the way that is unique to you?
Joel Theisen, BSN, RN, is founder and chief executive of Lifespark, a Minnesota-based complete senior health company.