[Webinar Recording] Live Well Today: Navigating Insurance and the Healthcare System

Polly Dawkins and Sara Chen discuss insurance while smiling.

In this Live Well Today webinar, Davis Phinney Foundation Executive Director Polly Dawkins discusses the complexities of the American healthcare system with Sarah Chen, a social worker who has worked in a movement disorders clinic for over 10 years.

You can listen to an audio version of this webinar.


Parkinson’s care can be expensive, and accessing efficient and affordable healthcare is an important part of living well today. Unfortunately, navigating insurance coverage and other aspects of the healthcare system can be extraordinarily complex.  


It is likely that you access and pay for healthcare services using some kind of health insurance. The most common types of insurance include private insurance from an employer, insurance you purchase for yourself through the Affordable Care Act’s marketplace, Medicare coverage you receive due to your age, or Medicaid coverage. 


Most people with Parkinson’s in the United States are eligible for Medicare. This is the federally funded insurance plan available to people 65 and older, as well as people who have been receiving Social Security Disability for more than 24 months.  

There are multiple parts of Medicare 

  • Part A helps cover hospital care, skilled nursing care, hospice care, and home healthcare. 
  • Part B helps cover outpatient care, home healthcare, durable medical equipment (wheelchairs, walkers, etc.). 
  • Part D helps cover prescription drugs. 
  • Part C is also known as Medicare Advantage. Medicare Advantage plans are offered by private companies and bundle coverage of Parts A and B. Medicare Advantage plans also often bundle Part D coverage. These plans may have lower costs and provide extra benefits such as vision, hearing, and dental services; however, they also tend to have restrictions on which providers you can see.

When you enroll in Medicare, you can choose to enroll in “Traditional/Original Medicare” and participate in Part A, B, and/or D. Alternatively, you can enroll in a Medicare Advantage plan.  

There is also Medicare Supplement Insurance, sometimes called Medigap: a supplemental insurance policy you can buy to help pay your share of out-of-pocket costs if you are enrolled in “Original Medicare.” 

Find more links to specific topics related to Medicare in the “Additional Resources” section below. 


Medicare Advantage plans have a few advantages—the most notable is that they’re a “one-stop shop” of sorts. They can also be less expensive. However, there are some details to consider that might make a Medicare Advantage plan less appealing to you. 

One downside is that Medicare Advantage plans tend to operate more like HMOs than PPOs. This means you will likely be limited in your choice of providers. This can be problematic, especially when you travel or as your Parkinson’s symptoms change and you need to see sub-specialists. There may be limited “in-network” providers, which can increase wait times for appointments.  Another possible downside is that if you choose a Medicare Advantage plan, you will not be able to use a Medigap plan. 


Any discussion of healthcare involves specialized terminology. Much of the specialized terminology in this webinar involves specific types of senior living communities and support agencies.  

Here are definitions of some key terms used in this webinar: 


An Area Agency on Aging is designated by the state to address the needs and concerns of the older population in a region or municipality. These agencies can help you understand what services are available in your area. They can also help you choose services and living arrangements that best suit you. 


Medicaid is healthcare coverage managed by US states according to regulations established by the federal government. Medicaid is offered to eligible people with low incomes and people with disabilities. Coverage and eligibility details vary state to state. 


The Medicare website defines long-term care as “medical and non-medical care for people who have a chronic illness or disability.”  

Most long-term care is not covered by traditional Medicare. Medicaid coverage may cover long-term care, but details vary state to state. Long-term care can be provided in multiple places; there are also long-term care insurance plans to help cover long-term care expenses, but there are limitations to these plans 

Your local State Health Insurance Program office or Area Agency on Aging can help you understand coverage in your area. You can also find more information about long-term care at the Administration for Community Living’s eldercare hub. 


The State Health Insurance Assistance Programs (SHIPs) provide local, in-depth, and objective insurance counseling and assistance to Medicare-eligible individuals, their families, and caregivers. To find your nearest ship, use this tool or call 1-877-839-2675. SHIP services are typically free. 


Because Parkinson’s medications can be expensive, when considering insurance coverage—including when considering whether to re-enroll in the same plan each year— consult the prescription coverage guide.  

Most insurance plans have a tiered system to determine cost and coverage for specific prescription drugs. A drug you take may change tiers from year to year and become more or less expensive. If you don’t see a prescription guide when enrolling in a plan, call your insurance provider to ask about coverage for your medications. You can also consult a SHIP counselor if you are considering Medicare coverage and need advice about coverage. 

Consider whether you and your care team are willing to explore tier exceptions, as this process can save money, but can be time-consuming. 

In addition to cost-sharing arrangements for your prescriptions provided by insurance, GoodRx and CostPlus Drugs are two resources that may help lower your out-of-pocket cost for medications—especially when a medication is not covered by your insurance or is otherwise too expensive through your insurance provider. 


Navigating insurance and the healthcare system can be daunting. The consequences of decisions you make about your healthcare coverage are significant, and there are so many options and so much confusing terminology. The whole process can feel overwhelming. 

But don’t be discouraged! From Area Agencies on Aging to the SHIP programs available across the country, help is available. As always, we are here for you, too. Please message us at blog@dpf.org if you have questions or need some support. 


Special Medicare Enrollment Periods 

Medicare: Joining a Plan 

Medicare: Help with Drug Costs 

Medicare: Find and Compare Providers 

Veterans Affairs Healthcare 

Every Victory Counts Manual and manual for Care PartnersWANT MORE PRACTICAL ARTICLES LIKE THIS?

You can learn much more about living well with Parkinson’s today through our Every Victory Counts® suite of resources. Each manual is packed with up-to-date information about everything Parkinson’s. Click the link below to reserve your manual(s).

Reserve Your Manual(s) Now

Thank you to our 2024 Gold Partner, AbbVie, and our Silver Partner, Mitsubishi Tanabe Pharma America, for their ongoing support of these must-have manuals. Additionally, we’d like to thank Barbara and Dale Ankenman, Abby and Ken Dawkins, Bonnie Gibbons, Irwin Narter, Lorraine and J Wilson, and Gail Gitin in loving memory of Gene Gitin for their generous donations that allow us to make these resources available and accessible to all. 

Share this post on social:

To receive our electronic newsletter and other updates, sign up now.

Related Posts

Back to top