Navigating the System: When You’re a Senior (65+)
MedicareMedicare is a US government health insurance program provided for Americans who are age 65 or older. It is also available to certain younger people (eg, those with disabilities and certain medical conditions). Medicare is paid for by taxpayers. Premiums are deducted from Social Security checks. While Medicare helps with the cost of healthcare, it does not cover all health expenses. The costs you pay include coinsurance, co-payments, and deductibles. There is also a range of services that Medicare does not cover at all. These added costs are referred to as “gaps” in Medicare coverage. Most people age 65 or older who are citizens or permanent residents of the United States are eligible for Medicare. Medicare has four parts:
In addition to healthcare from illnesses or emergencies, Medicare covers many preventive services, which can help find problems early, when they are most easily treated. These services include:
Talk to your doctor about the types of preventive services you need and how often you need them. Supplemental Health InsuranceThere are supplemental healthcare policies, called Medigap plans, which pay for some of the costs Medicare does not cover. It is up to you to decide whether you want to buy the supplemental coverage, because it is not provided as part of the basic Medicare coverage. However, there is another plan plan provided by privated companies that is approved by the government at an additional cost called the Medicare Advantage plan. If you enroll in it, you do not need a Medigap plan, since Medicare Advantage Plans provide many of the same benefits as Medigap plans. Medigap plans are sold by private insurance companies. There are standardized types of Medigap plans (A to G and K through N), each filling in different “gaps” and offering different benefits. Medigap plans may pay for extra days in the hospital, hospital deductibles, Medicare Part B deductibles, foreign travel emergencies, as well as other services not paid for by Medicare. Talk with a private insurance agent to find out what each Medigap plan offers. Study the plans carefully to decide if you need a plan, and if so, which one. For further guidance in this process:
None of the Medigap plans cover long-term care, vision or dental care, hearing aids, eye glasses, or private nursing. If you need this type of coverage, talk to your insurance provider about other insurance options that will cover these services. Health Services for SeniorsThe Administration on Aging (AOA) provides information on a variety of community-based programs aimed at meeting the needs of older Americans. The AOA can help direct you to a variety of health related services, including:
Administration on Aging Medicare Helpful Contacts Healthy Alberta Insurance-Canada.ca 2012 choosing a Medigap policy: a guide to health insurance for people with medicare. Medicare website. Available at: http://www.medicare.gov/Publications/Pubs/pdf/02110.pdf. Updated December 2011. Accessed August 6, 2012. Medicare. Social Security Administration website. Available at: http://www.ssa.gov/pubs/10043.html. Accessed August 6, 2012. Medigap: Your supplemental insurance. AARP website. Available at: http://www.aarp.or.... Published January 1, 2011. Accessed August 6, 2012. Prescription drug coverage: basic information. Medicare website. Available at: http://www.medicare.gov/pdp-basic-information.asp. Accessed August 6, 2012. Your Medicare coverage choices. Medicare website. Available at: http://www.medicare.gov/Choices/Overview.asp. Accessed August 6, 2012. Last reviewed August 2012 by Brian P. Randall, MD |
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