Medical Insurance for Senior Citizens – Overview
Seniors often find it challenging to get sufficient insurance cover as they age. They also struggle to keep their current health insurance with the rising cost of premiums and other insurance charges.
According to research by ERBI (Employee Benefit Research Institute), couples retiring at age 65 in the US need around US$ 280,000 in savings to cover potential medical costs.
This amount includes the premiums for Medicare Part B (doctor’s coverage) and Medicare Part A (prescription drug coverage).
Remember, this amount does not have the cost of assisted living or long-term care.
However, seniors who do not have sufficient savings mostly end up in heavy medical debt. An overwhelming majority of senior citizens struggle to cope with medical expenses.
It is advisable to get private health insurance, Medicare, Medicaid, and even Veterans Administration help at such a time.
These personal and public insurance programs can cover the cost of doctors, hospitals, nursing homes, assisted living facilities, and prescription drug charges.
Let’s check out the top medical insurance for senior citizens in the USA in 2022.
Medicare is considered the best medical insurance provider for people older than 65 years if they have worked full-time for at least 10 years in the past.
Medicare charges are partially covered by the mandatory 2.9% payroll tax and monthly premiums from enrollees and the government.
There are four parts of Medicare:
#1. Medicare Part A – Part A is free for most people and helps cover the cost of hospitalization, skilled nursing facility care, home health care, and hospice care.
#2. Medicare Part B – Part B costs around US$ 100 per month and covers the cost of outpatient services, lab tests, some surgeries, preventive care, mental health, clinical trials, and durable medical supplies and equipment.
#3. Medicare Part C – Part C (Medicare Advantage) comes at varying costs and lets you enroll in Medicare health plans sold by private insurance providers under contract with Medicare.
#4. Medicare Part D – Part D of Medicare health plans is dedicated solely to covering the cost of prescription drugs for policyholders.
Several different factors determine the exact cost of Medicare-covered insurance for senior citizens, including:
#1. Type of Medicare coverage chosen
#2. Kind of care and frequency it is needed
#3. If a doctor agrees to charge the patient the exact amount that Medicare will bear
#4. If other insurance policies can fill the coverage gaps
Medicaid is another government-run health insurance program. This is often the last resort for low-income individuals and senior citizens to seek medical insurance coverage.
To qualify for Medicaid, seniors must have a “spent down” majority of their available assets.
As the financial situation is confirmed, Medicaid will pay for most costs associated with long-term healthcare. This would include bearing the cost of skilled care services, nursing home care, at home and hospice care.
Senior citizens eligible for Medicaid are also considered “dual eligible” as they can also avail some Medicare benefits.
The rules governing Medicaid insurance policies vary significantly from state to state and can often be complicated. So, seniors must find their state’s specific terms and conditions relating to Medicaid.
#3. Private Health Insurance
Almost anyone can buy private health insurance policies as these do not have strict eligibility criteria. Some employer-sponsored health insurance plans continue to offer cover to policyholders even after they retire from work.
Still, private health insurance can be costly, as carriers tend to evaluate the premium rate according to the applicant’s health, age, and other risk factors.
Senior citizens with chronic medical conditions or predispositions are usually denied coverage. They do get insurance coverage in some cases but have to bear costly premium charges.
You can also buy Medigap, the Medicare supplemental insurance, from private health insurance providers.
These insurance policies offer to cover some of the costs not covered under Medicare. This policy also helps to pay deductibles and co-pays for Medicare.
You can also buy long-term care policies that cover the cost of services not covered by Medicaid or Medicare.
These may include covering the cost of assisted living, at-home health care, nursing home and hospice care charges.
Medigap is the Medicare Supplemental Insurance policy that covers the cost of health care needs not covered under original Medicare.
Medigap insurance policies help to cover out-of-pocket expenses for co-payments, coinsurance, and deductibles that Medicare does not cover.
You can apply for Medigap once Medicare pays its share of the approved amount for the eligible health care costs.
Medigap policies should not be confused with Medicare Advantage Plan, as Medigap is a supplement for the original Medicare plan.
Medigap insurance policies do not cover the cost of long-term care, eyeglasses, dental care, vision care, private duty nursing or hearing aids.
Every state has different criteria and procedures to apply for health insurance plans.
Make sure to consult with your doctor and the insurance representative to ensure that you are buying an affordable and efficient insurance plan.