Why Shouldn’t Take Senior Health Services in U S for Granted
Are you turning 65 soon and seeking health services? Seniors in the US contribute the highest rate of being uninsured. Among 65m seniors in the US, 6.5m exist without any health insurance. It’s like walking on thin ice; it might not look that bad, but you are playing with death and life. Life comes with various uncertainties, and good health forever is not promised. One overnight stay at a hospital costs thousands of dollars. So, if you are over 65, you should first enroll in health service insurance, considering the high healthcare service prices for uninsured personnel.
Why is Healthcare Service Important for Seniors?
Every 1 in 5 seniors in the US is without healthcare insurance! Yes, you read that right! This means that 20% of adults pay with out-of-pocket financing. It’s crazy, considering that an average hospital stay in the US is 4.6 days, and each day costs $2873 on average, totaling a whopping 13K from your pocket (No drug prescription is included in the total, too!). That’s a lot of money for a senior who might be prone to health issues. Fortunately, the US government comes in handy to provide ease to senior health services.
Options for Senior Health Services
There exists private and public health insurance for seniors in the US. The US government created Medicare (Part A and Part B) and Medicaid for public health services, insurance programs benefiting seniors with cost-effective and customized solutions. On the contrary, private health insurance may be heavy on the pocket, but it can provide extraordinarily fulfilling benefits if combined smartly with public health services. Medicare advantage plan (Part C) and Medicare supplement health insurance (Medigap) are Medicare-approved plans for seniors sold by private companies.
What is Medicare?
Medicare was founded in 1965 by the US government to provide relief to people over 65, specifically people under 65 with disabilities and people with End-Stage Renal Disease (ESRD), regarding medical insurance. Medicare contains three parts: part A, part B, and part D.
What does Medicare Cover?
Original Medicare comes up with a plethora of advantages. If you have a chronic disease, you can visit any doctor or healthcare worker that accepts Medicare without a referral, along with the coverage of medical supplies. No prior authorization is needed to get regular tests and treatments. If you are obese (BMI>30) and looking to lose weight, you can qualify for free nutritional assessments of up to 22 sessions.
Medicare can be availed in 2 ways: original Medicare or Medicare Advantage Plan. The Original Medicare insurance plan includes Part A and Part B, while Part D can be added separately if a drug prescription plan is needed. Original Medicare pays most healthcare services’ costs, but not all. In Medicare, you pay for services as you avail them.
Medicare Part A
Medicare part A (hospital insurance) covers hospital stays, skilled nursing facilities (excluding long-term stays), hospice care, healthcare clinics, critical access hospitals (CAHs), and some home care services. It is beneficial for seniors seeking health services.
Medicare Part B
Medicare part B (medical Services) covers doctors’ and ambulance services, laboratory and clinical research, medical equipment, and supplies needed for your treatment. Outpatient services and preventive care are also covered in Medicare part B.
Medicare Part D
Medicare part D (prescription drug coverage) covers prescribed medicines and drugs and does include vaccines and recommended shots. To get Medicare part D, you must enroll in an insurance program approved by Medicare (discussed below), which private agencies offer. Different agencies provide plans for part D, each covering all standardized drugs. Plans vary by cost in terms of the number of drugs included.
What is Medicare Advantage (Medicare Part C)?
Medicare Advantage plans are healthcare plans offered by private insurance agencies (contracted with the federal government) after approval from Medicare. Most Medicare Advantage plans cover Medicare part D and are another way of covering Medicare part A and Part B. HMO plans, PPO plans, PFFS plans, and SNP plans are the most common types of Medicare Advantage plans offered.
What does Medicare Advantage Cover?
Along with the advantages of Part A and Part B, Medicare provides:
Semi-private room facilities.
Nursing care.
Medical supplies.
Medical equipment.
Meals in the hospital.
Medications were administered during the hospital stay.
Stays in skilled nursing care are also included in Medicare Part C, doctor’s appointments, and ambulance services.
The range of services Medicare Advantage covers depends upon your chosen plan. Some plans include dental care, eye vision exams, prescription glasses, and contact lenses.
What is Medicaid?
Medicaid provides cost-efficient healthcare insurance to individuals with a lower pay scale. Medicaid, along with Medicare in 1965, was started by the US Federal Government, which partnered with the states to help people get cheaper healthcare services. Each state has its program, which abides by a particular set of rules the Federal Government provides.
What does Medicaid Cover?
Medicaid helps you pay hospital insurance (Part A’s) premium; the state will also pay part B’s monthly premiums. Medicaid also automatically helps with the drug prescription plan and may cover parts of drug prescription that Medicare doesn’t.
What is Medigap?
Medicare supplement insurance, aka Medigap, is a program offered by private insurance companies, which, as the name suggests, helps fill the missing “gaps” in the original Medicare insurance (Part A and B). Medigap makes your insurance plan payments easier by helping you pay coinsurance, copayments, and deductibles. To get Medigap, you must have Medicare part A and B, and Medicare part D is no longer sold with Medigap.
What does Medigap Cover?
Medigap covers all the remaining costs that Medicare doesn’t, depending upon the plan. It helps pay outstanding payments of deductibles, copayments, and coinsurance. Medicap also covers foreign traveling insurance as well along with skilled nursing care.
Private Healthcare Insurance for Seniors
A convenient option to get health insurance for people over 65 is private health insurance. Private healthcare insurance helps if you are going through a specific ailment or need treatment for one particular purpose. Private health insurance may cover benefits that Medicare originally did not, and you may get customized plans precisely per your needs within your budget.