An Arm and a Leg

By October 1, at least two million seniors will get alarming notices: Their health plans — which they got through Medicare Advantage, the version of Medicare run by private insurance companies — will disappear at the end of the year.   Many of them will be stuck without a lot of options. In some cases, no other companies in their area may offer Medicare Advantage plans to replace them. Almost three million seniors got stuck in similar situations last year, and experts say the scenario will likely keep playing out for years to come.  For years, critics have warned that Medicare Advantage plans expose seniors to big risks: The insurance company can decline to cover meds and treatment. And when they do approve treatments, finding a provider who takes your plan can be a huge challenge. Now, there’s a new and growing risk: Those plans could disappear, without a viable replacement. In this episode, we take a close look at the fallout in one state: Minnesota, where the collapse of a major Medicare Advantage carrier last year led to “total chaos,” according to the director of the state’s Medicare assistance agency — and where everyday heroes stepped up to support one another. Plus, we zoom out to look at how private health insurance companies have enmeshed themselves into Medicare as a whole, how that’s affecting the choices in front of us, and what we might do about it.  Looking for help with Medicare? Find your state’s SHIP chapter. Check out our previous episode on Medicare vs. Medicare Advantage.  Read about Medicare pitfalls to avoid: Part One and Part Two Here's a transcript of this episode.  Send your stories and questions. Or call 724 ARM-N-LEG. And of course we’d love for you to support this show.Support the show: https://armandalegshow.com/support/See omnystudio.com/listener for privacy information.

Hey, first!  If you value what we do, this is the best-ever time to support our work:  This month, every donation gets matched two-for-one.   We have SO much work ahead in 2026. Head to https://armandalegshow.com/support/ to donate — and get your money matched two-for-one. This statement might shock you: some actual good things happened in 2025. Or, at least things that did not totally suck.  Stuff like: new limits on the hoops insurance companies can make you jump through, and new protections from predatory debt collectors..   These are just a couple examples of what state governments have been up to this year – in red, blue, and purple states alike.  State governments can’t do it all, but across a couple of episodes, we’ll dive into a handful of meaningful wins, and learn how they came to pass.  Today’s episode takes us to Nebraska, where the state passed aggressive new restrictions on prior authorization.  And Virginia, where lawmakers banned wage garnishment for lots of medical debts. Here's a transcript of this episode.Support the show: https://armandalegshow.com/support/See omnystudio.com/listener for privacy information.

A listener named Thomas Sanford wrote to us earlier this year, asking for help with a little DIY project. And it’s turned into the most encouraging thing we’ve seen all year. With input from the Arm and a Leg community — specifically folks who get our First Aid Kit newsletter — Thomas has drafted a one-page handout, packed with resources for anyone who needs help with medical bills. It’s ready for you to use, and he wants your help making it better.  You’ll hear all about Thomas’s story — he’s a medical resident, who started out just wanting something to hand to his own patients — in today’s mini-episode. And now you can get involved. Thomas’s current version is great — and there’s also tons of room to improve it, with your help. Print out the current version and pass it around: Download it right here. Make suggestions for the next version: Anybody can comment on this Google doc. Volunteer to pitch in: Got design skills? Editorial chops? Language skills, to translate it? Other ideas?  Here’s a sign-up form. And you can make your own adaptations! Thomas has registered it with a Creative Commons license.  This project has been incubating in our First Aid Kit newsletter. If you’re not subscribed, this is a great time to sign up.  Here’s a transcript of this episode.  Send your stories and questions! Or call 724 ARM-N-LEG. Of course we’d love for you to support this show.Support the show: https://armandalegshow.com/support/See omnystudio.com/listener for privacy information.

Hey first! We need your help: Financial help. Donations from listeners power this show, and we’ve got a goal: 100 people making their first-ever gift, this week.  If you haven’t chipped in before, this is a great time — just click here. OK, onwards… Sharing a favorite from our archive – with lessons that are as relevant as ever.  Laurie Todd calls herself The Insurance Warrior. She fights health insurance for a living. Her speciality: writing appeals when insurance companies deny high-stakes, high-dollar treatments. Her first victory was fighting to get coverage for her own life-saving cancer surgery – which we chronicled in an episode tracing her origin story.  Since then, she says she’s notched hundreds of other victories, and outlined her strategies in two books: Fight Your Health Insurer and Win and APPROVED: Win Your Insurance Appeal in 5 Days. In this episode, we go deep on one of Laurie’s early, super-instructive cases, that taught Laurie one of the weirder truths about health insurance in America: fighting your health insurance often means fighting… your employer.  And in this case, that employer was a $61 billion company.  Want more about winning insurance appeals? Here’s our starter pack. Here is a transcript of this episode.  Send your stories and questions. Or call 724 ARM-N-LEG.Support the show: https://armandalegshow.com/support/See omnystudio.com/listener for privacy information.

As a follow-up to our series The Prescription Drug Playbook — all about how you can get the meds you need at a price you can (maybe) afford — we’re stepping back to look at the big picture.  From the start of this podcast, we’ve been trying to answer a major question: Why do my meds cost so freaking much? And we’ve highlighted the profit-seeking games that insurance, pharma, and middlemen play all around us in more than a half dozen episodes.  But there’s one set of players on the field that we’ve never talked about: drug distributors, and how they play a role in another reason you may not be able to get your medicine: drug shortages.  This story comes from our friends at Organized Money, a podcast about monopolies, from writers and journalists David Dayen and Matt Stoller.  We think you’re going to like it.  In the meantime, check out the latest installment of our First Aid Kit newsletter for a rundown of our previous coverage of drug costs.  Here’s a transcript of this episode. Send your stories and questions. Or call 724 ARM-N-LEG. Of course we’d love for you to support this show.Support the show: https://armandalegshow.com/support/See omnystudio.com/listener for privacy information.

Too many of us get sticker shock when we go to pick up our meds.  We asked our listeners how they get by in this situation, and we learned dozens of tips. And in this two-part series, we’re sharing those strategies — including some advice from experts. The next episode drops June 30. Support the show: https://armandalegshow.com/support/See omnystudio.com/listener for privacy information.