If you’ve ever tried comparing healthcare plans for seniors, you know that it can be overwhelming. How do you know which plan will best suit your needs? Are you paying too much? Who can you trust for good advice?
Finding the right plan for you requires research into all of the available options. Here are the basics on the two most common choices for covering senior healthcare costs: Medicare and Medicaid.
Medicare is a federal health insurance program for people who are 65 or older. It is also available to certain other groups. There are four parts to this program, Part A, Part B, Part C, and Part D. Each one of these covers different services. Medicare Parts A and B are also sometimes referred to as original medicare. Most people don’t have to pay a premium to receive Part A benefits, however, Parts B, C, and D require monthly premiums.
Medicare Part A
Medicare Part A covers hospital stays, limited time in a skilled nursing facility, some home health care services, and hospice care.
Medicare Part B
Medicare Part B covers doctors’ office visits, outpatient care, medical supplies, and certain screenings, x-rays, and blood tests.
Medicare Part C
Medicare Part C is also known as Medicare Advantage. It is offered by private insurance companies who have contracted with the Centers for Medicare & Medicaid Services to provide coverage as an alternative to original Medicare. Many of these plans cover services that aren’t covered under Parts A and B, such as eye exams or hearing aids, and most of them also include prescription drug coverage.
Medicare Part D
Medicare Part D is prescription drug coverage that can be purchased in addition to plans that do not offer this feature. Part D plans are also offered through private insurance companies, and the premium you pay will depend on the plan and company that you choose.
Depending on your specific circumstances, you may decide to enroll in one or more of these programs. It is a good idea to reevaluate your health insurance regularly to determine if your current plan is still the best for your health needs.
It’s also important to note that Medicare plans do not typically cover long-term stays in skilled nursing or assisted living facilities. For ideas on covering the costs of long-term stays, see our past post on Financing Senior Care Costs.
Supplemental Insurance Plans for Seniors
Even with one of the previously described senior health plans, the cost of co-payments, coinsurance, and deductibles can add up quickly. If you are enrolled in Medicare Parts A and B, you have the option to purchase a Medigap plan to help cover some of these expenses.
Medicaid is available to certain low income individuals, including many seniors. Medicaid services are partly regulated on the state level, so eligibility requirements and covered services will be different depending on where you live. The federal government requires all states to cover certain services. These include:
- Inpatient and outpatient hospital services
- Physician services
- Long-term stays in skilled nursing facilities
- Home health care services
- Laboratory services and x-rays
- Federally qualified health-center (FQHC) services and ambulatory services
Even if your current income doesn’t allow you to receive services through Medicaid, it’s advisable to be aware of eligibility requirements in case your circumstances change in the future.
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