Learn This Guide to Senior Health Benefits – Options and Costs

• Part C, often known as Medicare Advantage, has a range of costs and allows people to enroll in Medicare health plans marketed by private insurance firms that have contracts with Medicare.

• Part D assists with the expense of prescription drugs.

The overall amount a Medicare-eligible senior may wind up paying for health care will be determined by a number of factors, including:

• The type of care required and how frequently it is required.

• The kind of Medicare coverage selected.

• Whether a doctor agrees to charge the same amount for a service that Medicare will reimburse.

• Whether additional insurance plans are available to replace gaps in coverage. 

Medicaid

Medicaid is a health insurance program administered by individual states and funded in part by the federal government. It is the last resort insurance for low-income people, especially seniors.

To be eligible for Medicaid benefits, a senior must have “spent down” the majority of his or her available assets. Once the financial floor is met, Medicaid will cover the majority of the costs associated with several types of long-term health care, such as nursing facility care, skilled care at home, and hospice care.

Because they may also be insured by Medicare, some seniors who qualify for Medicaid are referred to as “dual eligible.” Medicaid laws differ from state to state and can be complicated, so low-income seniors should research how their state’s program operates and how to qualify for benefits.

Private Health Insurance Plan

Individuals can acquire private health insurance coverage, or corporations can provide them. Most employer-sponsored policies, unless they are part of an employee’s pension or union plan, expire when a person retires, therefore private health insurance only covers a small number of seniors. Individual private plans can also be expensive because carriers consider an applicant’s health, age, and other risk factors before providing coverage.

Seniors with major medical issues or predispositions to illness may be denied coverage or pay excessive premiums. Medicare Supplemental Insurance, or Medigap, is also sold by private insurers.

These plans cover expenses that Medicare does not cover. They are also useful for paying Medicare copayments and deductibles. They also sell long-term care policies, which help pay for services such as home health care, assisted living, hospice care, and nursing homes that are not covered by health insurance, Medicare, or Medicaid.