The Commonwealth Fund

John Raite, a SHINE (Serving the Health Insurance Needs of Elders) counselor, assists a senior who needs help with her Medicare choices. More than half of State Health Insurance Assistance Program (SHIP) coordinators surveyed said Medicare beneficiaries learned about the SHIP program via word of mouth through their social networks and from referrals from government agencies that provide benefits or social services. Photo: Mike Stocker/South Florida Sun Sentinel/Tribune News Service via Getty Images

Whether retired, nearing retirement, or living with a disability, most people with Medicare coverage live on fixed incomes. This means they’re acutely affected by the cost of their health care. While Medicare provides a guarantee of coverage for most medical services, beneficiaries still contend with copayments, deductibles, and costs for uncovered services — much like other Americans with private health insurance do.

The Medicare open enrollment period — a time when beneficiaries can change their coverage — began October 15 and runs through December 7. Medicare beneficiaries receive benefits either through traditional Medicare or a private Medicare Advantage (MA) plan. Deciding between these options and also among Medicare Advantage plans can be challenging: the coverage options have trade-offs, and beneficiaries have diverse needs.

Issue: Maternal mortality rates in the United States exceed those of other high-income countries, and this largely preventable crisis disproportionately affects Black women.

A nurse at the Albblick nursing home in Filderstadt, Germany, pushes a resident along a corridor. Compared to their counterparts in most other wealthy countries, older Americans have greater difficulty affording health care, despite having Medicare coverage. Photo: Marijan Murat/DPA via Getty Images

Dr. Vicki Noble, a primary care physician, stands in front of the VA Outpatient Clinic in Springfield, Mass., where she works. She left her previous practice because she was required to see more patients than she thought was safe. Our survey found that nearly half of physicians reported they were burned out. Photo: Pat Greenhouse/Boston Globe via Getty Images

An employee works at her computer in a home and office furniture and accessory store in Santa Fe, N.M. Even within the same state, many workers pay much more for their share of health insurance premiums if they work for a small business versus a large company. Photo: Robert Alexander via Getty Images

Seniors Siglinde and Norbert Neumann use a tablet for communication with their family doctor on July 19, 2019, in Halle, Saxony-Anhalt, Germany. The U.S. can learn a lot from Europe about how to better implement remote patient monitoring. Photo: Jan Woitas/picture alliance via Getty Images

Nurse Yesenia Aguirre (right) gives a COVID-19 vaccine to Francisca Chavez at the Mexican consulate in Glendale, Colo., on August 22, 2024. More than half of Hispanic/Latino working-age adults surveyed recently experienced problems getting health care because of the cost. Photo: Hyoung Chang/Denver Post

Lincoln Health Community Hospital in Hugo, Colo., on October 23, 2024. As America’s aging population demands greater access to care, several states are making efforts to recruit and retain clinicians in rural areas. Photo: Aaron Ontiveroz/Denver Post via Getty Images