We spend a lot of time talking about food, supplements, toxins, and exercise. All the things you can do to take control of your health. But one thing most people overlook is their Medicare plan. Now, it actually can determine which doctors you see, what prescriptions you can afford, and whether you can get the care you need when you need it. Now, I’ve seen this with my own patients more time than I’d like. That’s why I brought today’s special guest on, because real solutions exist and most people just don’t know about them. Today, I’m joined by Ari Parker, co-founder and head of Medicare Advisory at Chapter, a company that’s helped hundreds of thousands of people navigate Medicare. Now, Ari is a Stanford trained attorney, bestselling author of It’s Not That Complicated, and his work has been featured in the New York Times, The Wall Street Journal, and Forbes.

(01:04)
So in just a bit, we’ll reveal how people end up on the wrong plan, why the advice they’re getting isn’t always unbiased and how to find coverage that actually fits your life. So we’ll be right back.

(01:22)
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(02:33)
Ari, welcome to the program.

Thank you so much for having me, Dr. Gundry. Thank,

Thanks for coming. Tell us how you founded this idea in the first place. Uh, you know, I, I think it had to do with your mother, right?

Well, the reason that we started Chapter was because of our parents. So I’m going to speak to my mom and dad. My mom has late enrollment penalties as a result of not signing up for Medicare when she should have. Oh.

She was

Two years late to the party. So as a result, she owes a 20% lifetime penalty because she signed up two years late. And that’s something people may not realize. If you don’t sign up on time, you may owe a late enrollment penalty and it’s totally avoidable so long as you know what you need to know before you start Medicare.

I don’t recall somebody telling me that, “Boy, I better sign up at 65 or I’m in trouble.”

The government is not doing a very good job if even doctors don’t know what they’re supposed to do with respect to their Medicare deadlines and whether they need to enroll or not. And that’s why we start a chapter. It really isn’t that complicated. In a one-on-one consultation, our advisors will tell you everything that you need to know, including whether you need to sign up for Medicare in the first place. Some people don’t. For example, if you’re still working or you’re on your spouse’s insurance-

Right.

… then you may not need to sign up and we’ll give you what you need to know and then how to action it. We’ll help you get your red, white and blue card. It takes less than five minutes to do online.

So I do have a number of patients who maybe the, the husband is still working, but the wife is retired or vice versa and whoever is still working is still on the employer’s plan and they’re over 65. If they’re still on their employer’s plan, can they get on Ma- Medicare without a penalty after they come off their employer plan?

The short answer is yes. It’s the rule of 20. As long as the employer has 20 or more employees, then they don’t need to start Medicare. Instead, when they’re ready to retire, that’ll be when we help them go to Medicare. Same thing applies to their non-working spouse. With that said, it’s important to do an apples to apples comparison for the non-working spouse because oftentimes employers subsidize your insurance, you know this.

Yep.

But they don’t subsidize the non-working spouse’s insurance. So they might be paying an arm and a leg for something that they can get more affordably through Medicare and they’ve paid into the system already. So if it’s a better deal to start Medicare, they should transition to Medicare. It’s great insurance.

Would I, as an employee, um, know whether my employer has more than 20 employees?

Yes. You would know whether the employer has 20 or more employees. Someone in the company, even if it’s a small company, should be able to answer that question.

I see this all the time. I see this in advertising. I see so many of my patients trapped in what they’ve been told is a great Medicare plan. I see it advertised on TV, literally constantly. I have a bias that I probably won’t talk about about certain advantage programs. Mm-hmm.

(05:57)
Um, so I see a number of my patients who they’re doing all the right things, that’s why they’re seeing me, but even people who are doing the right things often end up with a health problem that needs a referral to a specialist. And lo and bold, that comes to finding a specialist and they realize that they’re trapped in a system where they can’t go to the specialist that I think they should go to or somebody else smarter than me thinks they should go to because they signed up for a system that pigeonholes them into, “No, this is the only way you’re going to be served.” How do you guys help people figure that out?

You, you raised a number of important points. I want to unpack them. The first thing is that original Medicare, that is Part A, which covers your hospital insurance and part B, outpatient coverage only covers 80% of your medical expenses. So you need coverage for the other 20%. So what do people do to cover the other 20%? Well, they only have two options. The on that’s advertised on television, which is Medicare Advantage and Medicare Advantage, as you mentioned, has a lot of trade-offs because it’s a replacement for original Medicare administered by a private insurance company and subject to that private insurance company’s terms and conditions, including network restrictions. It is managed care. It limits your choice of doctor, it limits your freedom and you may need to get your doctor’s permi- you may need to get the insurance company sign off in order to get the procedures that you need.

(07:45)
The other option is Medicare Supplement, which is also known as Medigap. This sits on top of original Medicare and it covers the 20% that you’d otherwise owe out of pocket. It’s more comprehensive and more flexible. It, it does come at a higher cost commonly than Medicare Advantage. There’s a higher monthly premium. So those are the two options and that’s what we help people address every day at Chapter.

So when somebody picks up the phone and calls this Medicare Advantage number that’s being advertised, you’re basically, correct me if I’m wrong, talking to a salesperson who is selling-

That’s right.

Right?

That’s right. Not only if you call the insurance company, you’re talking to a salesperson who’s captive- Right. … to that insurance company.

Correct.

They’re only offering you that insurance company’s offerings.

Correct.

That insurance company’s offerings might not cover the doctors, the specialists that you want to see, the hospitals that you want to go to. It might not cover your prescriptions affordably. It might not meet your priorities. As you mentioned, there’s this whole other type of coverage, Medicare Supplement. Are they helping you choose Medicare Supplement versus Medicare Advantage, or are they only offering you a subset of Medicare Advantage plans? What people need to realize is if you are going to go the Medicare Advantage route, there’s hundreds of insurance companies offering thousands of plans and those plans vary zip code by zip code across the US. So if you want an exhaustive search of all your options, the only company that has a platform that marries your three Ps, your providers, your prescriptions, your priorities, two, the plan that’s best suited for your needs is chapter.

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That’s code Gundry for an exclusive 20% off. And if you see a post-purchase survey, mention that you heard about Cozy Earth right here. There’s a lot of commercials for travel companies and they say, “You should have gone through Trivago because we compare the various prices of hotels and plus- Right. … and we’ll

(12:15)
Find you the best price.” We’re not trying to sell you a hotel. We’re, we’re a service that sorts out, okay, who’s got the best price and who’s got the best features for your dollar. So you guys are not trying to sell somebody on a plan. Is, is that correct?

It’s not about selling anything. Instead, it’s about taking a personalized approach.

Right.

So an airline search engine doesn’t really do it justice because you’re just buying a seat on a plane. It’s a flying bus. That’s not true of your healthcare. This is true. What matters for your healthcare, what doctors do you wanna se? What institutions do you wanna go to? Cedar Sinai, Mayo Clinic, MD Anderson in Texas really matters.

Right.

What prescriptions do you take, brand name or generic? And then what are your priorities? Do you own a second home? Do your grandchildren live in a different state? Do you plan to travel internationally in your colding years? All of this matters for choosing what type of coverage you ought to be on. And it’s that personalized one-on-one approach that’s so critical, which isn’t something that these airline search engines are offering.

Very true. When somebody’s calling the number for Medicare Advantage, you, you’re right. You’re, you’re only talking to the salesperson for that company. And my father was executive vice president of Mutual of Omaha Insurance, so I, no insurance. And that’s all they’re doing is selling their particular company’s plan. And it sounds wonderful because you get free dental and free eyecare and free everything. Mm-hmm. And it sounds great, but nobody reads the fine print that, well, f- for all this free stuff, you’re losing a lot of stuff. Is that correct?

Yes. What you’re referring to are the goodies that Medicare Advantage plans advertise. So if we go back to our framework, Medicare supplement sits on top of original Medicare and covers the 20% of medical expenses. Medicare Advantage is a replacement for original Medicare and to entice people to sign up for it, they offer things that original Medicare doesn’t cover, like dental, vision, and hearing. Over the counter benefits, the list goes on. So that’s what Medicare Advantage plans tend to focus on. What they don’t focus on is how the plan covers your doctors, your specialists, your prescriptions. That’s not what they tend to highlight. Instead, they’re highlighting the goodies. But those goodies come at a tremendous cost. Those goodies tend to be much more lucrative for the insurance company, right? If you only go to the dentist and get two cleanings per year, it is advisable to pay out of pocket for those cleanings rather than to have a trade-off in terms of the doctors that you can see.

(15:09)
That’s my two cents.

So how aware are people when they’re getting this pitch that a lot of, actually a lot of their flexibility in finding hospitals, physicians has been taken away from them.

What people may not realize is that this is highly consequential. In 46 states, you have a on- time opportunity to sign up for Medicare supplement without questions about your health history and something as common as type two diabetes and hypertension, which affects about 30 to 35% of the senior population- Yep. … can be a non-starter once you’re outside that six-month window in 46 states. So when you first start Medicare, it is really important that you know what your options are and the good news is that there’s broadly speaking two options, Medicare Supplement or Medicare Advantage. For Medicare supplement though, you are time restricted in the vast majority of states as to when you can obtain it unless you have a guaranteed issue right, which are few and far between.

How do you guys … First of all, do you say w- well, you’re gonna pay us a lot of money to figure this out for you because, because I’m an attorney and I like making money.

Uh, but I don’t practice law. Right. Uh, because the law, the wheels of justice turn slowly and in the law, you’re only helping one person at a time.

True.

With Medicare, there are 73 million people already on Medicare and there’s over 11,000 people turning 65 every day.

Oh.

So the pace at which we can help people is so much greater being involved in Medicare than practicing law.

Take me through it. How do you navigate somebody telling them their choices?

So here’s, here’s how we do it. Let’s use you, for example. Dr. Gundry, I wanna go over your three Ps, your providers, the doctors that you see, your prescriptions, your list of medications, brand name, generic, dosage, what pharmacy you like to go to and your priorities, what’s important to you. And so then we have a 20 to 30 minute conversation about those three Ps. It all starts there. While you’re speaking, I’m using our platform to enter your three Ps and it has a list of every insurance company and every plan available in your zip code. We’re here in Southern California and then it provides a short list of options for us to discuss.

You literally go, you know, “Here’s what they offer, they offer, they offer. Here’s what is probably gonna work for you. Here’s, you know, but you, you get options. So, so this is very different than, you know, what I see on TV. You know, it’s time to get Medicare and call this number because boy are there all these free goodies. And you’re just talking to that one provider, whether it’s Mutual of Omaha, whether it’s UnitedHealthcare, whether it’s Humana, you name it. Whatever number you call, you’re not getting that individualized breakdown.

Mm-hmm.

Right?

Well, people are bombarded by unsolicited mailers- Yeah. … spam text messages- Yep. … phone calls, nonstop. And it starts when they turn 64 and a half. But what people should know is that even if you didn’t have the chance to review all your options, it’s not set it and forget it. You can still take action and do something about it. We might even be able to help you make an adjustment now.

So

If you haven’t reviewed your coverage, it’s really important to see how we can help and m- maybe you have a window that might allow you to make a different coverage choice that’s more comprehensive, more flexible, and provides peace of mind and better coverage at a lower cost.

We hear about in, kinda in the summer and early fall that the time to change Medicare is coming up.

Mm-hmm.

That happens, as I understand it, once a year. Mm-hmm. Once a year, you can reassess this. Is that something that it’s almost like the yearly visit to the doctor? Is this something that once a year we should check in with you saying, you know, “Maybe my priorities have changed. Maybe my health has changed.”

It’s great advice. Everyone should do an annual checkup on their Medicare coverage. The general time to do it is during the Medicare open enrollment period- Right. … which is October 15th to December 7th. That said, you might be able to change your coverage sooner than that and for example, physician networks on Medicare Advantage plans can even change midyear, which is something people don’t realize. Even if you thought that your doctor was in network at the beginning of the year, that might’ve changed.

Right, because they negotiate contracts with insurance companies.

I don’t have to tell you twice.

I, um, we used to do that all the time and often the, you know, the lowest bidder wins and, you know, all of a sudden people like my patients go, “Wait a minute, I, you know, I was seeing so- and-so and now I can’t see so- and-so.” Uh, what happened? And it’s because they were in a group that renegotiated a contract and they were not the lowest bidder. Mm-hmm. Yeah. And this is fair, right? I mean, this is what, this is what happens.

That is how unfortunately the American healthcare system works at this snapshot. Hopefully, there are going to be improvements. We are leading the way our CEO testified in front of the Senate Finance Committee in order to get some of those improvements instituted. We’ll see, but we are fighting in order to improve the Medicare system overall and the change like you mentioned, doctors leaving their networks in the middle, middle of the year, what does someone do if they selected that plan upfront because of the network and then the network changes? Shouldn’t they be allowed to then change their plan midyear?

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(22:45)
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(24:18)
Mm-hmm. And that other hospital has their own in- house set of doctors. The doctors are basically employed by the hospital, which is becoming more and more.

Yes. Way more common, right, than my, my father was a physician and he ran his own practice.

Right. Now, you know, hospitals are buying up and hospitals are buying up each other. And what’s happened in, in our town of Palm Springs is now all of a sudden people who carry this particular insurance who were coming to our hospital, coming to their doctors now have to go to the other hospital, which is way across town and have to see an entire set of doctors. Different. They had, had to say goodbye. Mm-hmm. So can you help negotiate that sort of, uh, in the middle of the year?

Potentially.

Yeah. But it’s worth looking at.

It’s worth looking at. That’s exactly right. So if someone has experienced the coverage disruption, but maybe we can help, maybe we can’t help until the fall, but we’ll give you the information that you need to know and it depends. That’s the long and short of it. And I think Palm Springs is also a great example because there’s a lot of little Medicare Advantage insurance plan. So if you are inclined to go the Medicare Advantage route, it’s really important to know how many insurance companies there are offering plans and some of those plans can work exceptionally well. Are you working with someone who can tell you whether that plan would work well for you or not?

Medicare Advantage, I don’t, uh, I don’t wanna badmouth it, but there are benefits-

Have a use case. Yeah.

But even between Medicare Advantage plans, there are differences.

Big.

So it’s not just one, okay, wait, everybody gets this with Medicare Advantage.

There’s no one size fits all approach and that’s why it has to be a personalized conversation with someone who’s independent and unbiased. And we are the only Medicare advisory that has created a fiduciary-like standard for our advisors. And that’s really important. Our duty is to the person we’re speaking to in order to help them find the very best coverage based on their three Ps, providers, prescriptions, priorities. That’s it.

So three Ps, providers, prescriptions, priorities. So you’re actually asking people, um, is it more important for you to be able to get your prescription drug as the actual drug or is a generic okay for you? Is, you know, is that important to you? Yes. Ex- one example.

That’s not our call though. That’s their doctor’s call. Some people, for example, levothyroxine.

Right.

They tolerate the generic for levothyroxine the vast majority of the population does.

It’s a thyroid medication.

Oh, thank you. Yeah. Some, some, we’re in the weeds here.

Okay.

Some people though, they need to be on Synthroid.

Correct.

Because they have serious side effects from taking the generic.

Correct.

That’s not our advisor’s call to make. That’s your doctor’s call. And if your doctor says that you need Synthroid because of the side effects you have to levothyroxine, the generic, then we are going to fight to the end of the earth to make sure that we help you get Synthroid. How do we do that though?

All right. How do you do that?

We do it by not only having a advisor that fights for you, but also a member advocate, which is your first line of defense for any hiccups that happen during the course of the year. So for example, you need a brand name medication like Synthroid. We will try our very best to help you obtain it. Oftentimes there’s just a prior authorization form that your doctor needs to fill out. I’m sure you’re familiar with this.

Oh, yeah.

All right. So we get that form filled out, we get it back to the insurance company. Oftentimes that’s good enough. Sometimes it becomes a more prolonged battle and we are fighting for you every step of the way. You get a claims invoice you don’t understand. These are written in hieroglyphics. They’re hard to decipher. Our member advocate team will help unpack it for you. You lose your insurance card, we’ll help you get a replacement. All of these are things that our member advocate team is designed to assist you with. And so it’s not a one and done relationship. You reach out to your advisor, your chapter advisor, you reach out to the chapter member advocate team and we will help make sure that you are getting the most out of your Medicare coverage.

Yeah, I think for anyone listening or watching, this is a really important point because insurance companies, God bless them, wanna throw everything in your path to getting the things you need or your doctors want you to have. And so a lot of times I’ll want a test on, on a patient, which maybe costs a lot of money and it’ll be denied by the insurance company, but we’re allowed to request a, you know, a hearing, if you will. And we’ll submit, “No, here’s why you have to do it. ” And then let’s say you have to talk with one of our physicians. The problem is I’m very busy. Most doctors are very busy. The staff has to track down the physician that the insurance company wants you to talk to. That physician is very busy and I’m very busy and what they’re planning, what they know you’ll do is after four or five attempts to get this call, you’ll give up and it happens all the time.

(29:55)
So what you’re saying is you, you will be the per- … Person who keeps pushing that button to-

That’s exactly right. We have the playbook on how to fight back and we will fight, fight, fight to make sure that what someone’s doctor says someone needs we help them obtain to the best of our abilities.

Let me tell you, as a practicing physician, it’s a big deal because you just … I understand insurance companies wanna make money and you understand they wanna save money, but they do it in ways of, you know, questioning a physician who most of the time is ordering a test because he really wants to get that information. Um, he do- we don’t do it just for fun. “Hey, let’s get a CAT scan on your brain.

“What do you say? Exactly.

So this is, this is really, this may be the, uh, the most important point we’ve heard today, that you’ve got an advocate that fills in for when I or my staff, uh, are getting roadblocks. Right.

And we liaison with the insurance coordinator at the physician’s practice and we keep the trains on time so we don’t lose track of where you are in the appeal or grievance process so that way you can access the care that your physician thinks you need. Why does the insurance company get a veto over that?

Believe it or not, we, we try not to order frivolous tests. <laugh>

Shocker.

It’s, the patient’s busy, you know, the physician’s busy. Uh, that’s the last thing I wanna know. “Hey, what a, that, what a, what a cool test. Let’s, let’s order that. “No, we, or a test to get information. And a lot of times the insurance company … And some of these tests are expensive and-

No doubt.

And insurance company says,” Ooh, that hits the bottom line.

“And to be clear, there have been, uh, there has been fraud, waste and abuse in the Medicare system.

Oh, yes.

That is not what you and I are talking about right now.

Right. We’re not talking about, I also, I don’t, but many physicians own ancillary services, whether it’s a physical therapy service, whether it’s a radiology service and where a lot of the fraud and abuse comes from is the physician-

The wound bandages. Yeah, exactly. And the durable medical equipment sometimes can be rife with abuse. Correct. We, there’s been

No- We’re not talking about that. We’re talking about legitimate tests that people need or services that people need, right? All right, this is great. So any, any last thoughts you wanna add on this conversation to help our audience?

Just going back to what we were discussing, we discussed a lot about people who are approaching Medicare. Right. There are many people in your audience that we can help today. Many people who are viewing this are already on Medicare. If you haven’t done a check in a couple years, let’s make sure that you know all the options that are out there and there’s no charge. So have a personalized one-on-one conversation with someone who’s independent and unbiased.

And to everyone watching if you’re on Medicare or getting close to 65, please don’t wait until there’s a problem to you review your plan. You know, I brought Ari on as I feel that this is actually a real solution to a real problem that I see with my patients. So, you know, Chapter can help you. Compare your options for free and we’ll put the link in the description below. Now, uh, Ari, uh, we usually have an audience question. Uh, we’re gonna open up the audience question to you. Anything on your mind you’d like to ask me before we go?

Yes, I heard you actually used to drink Diet Coke. I am unfortunately a Diet Coke addict.

So is I.

We’re talking maybe four cans a day.

I was eight.

Wow.

Eight a day.

You had me beat.

Yeah.

So, uh, why’d you give it up?

So, um, number one, it, it is addictive. Um, there’s several reasons why it’s addictive. One is you and I don’t have sugar receptors on our tongue. We have sweet receptors. We also have sweet receptors in our intestinal lining, believe it or not.

Really?

We do. And long ago, the only sweet things were fruit and honey that we would ever eat. And our, these receptors were looking for sweet, not sugar. Obviously, it was sugar. So when our tongue tastes sweet, it sends a message to our brain that sugar is being ingested. The brain says, “Okay, I’ve got to handle sugar and I’m going to squirt out some insulin out of the pancreas to handle that sugar, to sell it to the muscles, to get it ready for my brain.” And when that happens and sugar doesn’t arrive, your blood sugar actually goes down and your brain goes, “What the heck? I didn’t get any sugar. I’ve been cheated. You’ve been cheated. Go find some more and keep doing it. ”

That makes sense. So you overeat.

You overeat and it’s been shown over and over again that this is a very powerful stimulus to overeat. That’s why I was running 30 miles a week going to the gym one hour a day- Wow. … and I was 70 pounds overweight. And it was like, “What the heck?” You know, I was called a Clydesdale runner. It’s a Clydesdale runner. The Clydesdale runner is a big fat guy who runs. <laugh>

Oh my

Gosh. Seriously, we, there’s club, you know, the Clydesdales. And <laugh> there’s also that hash house Harriers in the running community. These are drinkers with a running problem.

Hmm.

So that’s number one. Number two, we now know that the sweeteners in Diet Coke kill off the microbiome, your good bacteria and it replaces them with bad bacteria. And that’s been my research for the last 20 years. So it’s in my humble opinion, uh, not a good idea. Mm. But it’s very addictive. I was just on a show yesterday with, uh, with an actress who had a, a diet Coke addiction and, you know, we, we were just chatting about that. She said, “Oh, it’s real.” Mm-hmm. I said, “Tell me it’s

Real.” It’s real.

It’s real. Yeah. So wean off.

Wean off.

How’s that? Now it’s time for the question of the week from at Ilka Molnar 6115 over on YouTube on my episode about Leaky Gut. They asked Dr. Gundry, you’re a blessing. Thank you. Will Total Restore Heal Leaky Gut? Well, that actually is a very, very good question. Yes, I formulated Total Restore to have all the components to help heal a leaky gut. What I’ve learned in treating people’s leaky gut for over 25 years now is yes, I can give you the components to help seal your leaky gut, but if you keep swallowing what I call razor blades, things like lectins, plant defense compounds, then you will slice it right open. I’ve even done this on myself so yes, it really helps, but you gotta do more work. Thanks for that question. I hope that helps you understand. Now it’s time for the review of the week from @DavidSola6691 over on YouTube on my episode about which fruits you should be eating.

(37:57)
They said, “Thanks, Dr. Gundry for helping educating us. My family loves berries, God bless, and a heart emoji and a prayer.” Well, thanks a lot. I’m, I’m trying to give you the most up-to-date information that I’ve learned from my research but what my patients have taught me for over 25 years. So thanks for writing. Appreciate it.

At first, I didn’t think it was real. I woke up to this blinding light and I was transported to another place. Pluto TV. Then I heard a voice.

Come with me if you wanted to live.

There were thousands of movies and shows and they were all free. The truth is. It’s just so beautiful.

On Pluto TV, free streaming of Terminator two, Fringe Arrow, the 100 and the X files may cause excitement, loss of sleep, and sudden belief in extraterrestrials, no credit cards or alien encounters necessary. Pluto TV, stream now, pay never.

That’s a wrap on today’s episode. And before you go, I wanna leave you with one task. If anything you heard today made you think made you wanna dig deeper or gave you something you’re going to pass along to someone you care about, please take 15 seconds and leave a five-star rating and review on Apple Podcasts or Spotify. I know that songs small, but those reviews are how Apple and Spotify decide which shows to surface to new listeners. And this show only grows when people who’ve never heard of it suddenly find it. That person finding this podcast today could hear something that genuinely improves their life or the life of someone they love, maybe even saves one. Everything I share here comes from my research when writing my next book and my clinics, where I’ve been seeing patients six days a week for over 25 years working with nutrition and supplements as the primary treatment.

(40:03)
This is real world medicine. Help me get it to more people and thank you. Truly thank you. I’m Dr. G and I’m always looking out for you.