Health Insurance For Senior Citizens

Is there any health insurance for senior citizens? How old does one have to be in order to qualify for such coverage. Keep on reading to find out.

Growing older automatically comes with increased health risks which makes it important for senior citizens to have appropriate health care options to live a comfortable life. The United States spends twice as much on medical care as the rest of the developed countries in the world. 18% of the gross domestic product (GDP) generated by the U.S. every year goes to help the country’s medical care system. And what about health insurance for senior citizens? The percentage of the U.S. economy spent on medical services for people ages 65 and above surpasses 5% — a proportion that is expected to double by 2030 and triple by 2050.

As seniors age, they may find it hard to manage the cost of increased medical care costs – similar to when their pay is decreasing. As per a new report by the Employee Benefit Research Institute (ERBI), a U.S. couple resigning in 2017 at age 65, required $280,000 of savings to take care of future clinical expenses. The $280,000 incorporates premiums for Part B doctor coverage and also Part D medication coverage. It does exclude long-term care or assisted living. This article will cover important details regarding health insurance for individuals who are 65 or over 65 years old. So continue reading to learn the details.

Is there any Health Insurance for Senior Citizens?

Medicare

Medicare is the government health insurance program for seniors who are older than 65, who have worked full time for at least 10 years. Medicare is paid for by a blend of a compulsory 2.9 % payroll tax evaluated to all laborers and businesses, monthly premiums paid by the enrolled, and by the federal authority. (As of January 2013, an extra 0.9 % tax is charged on people whose earnings surpass certain limits: $250,000 when married and filing together, and $200,000 for single filers.) Medicare has four sections:

  • Part A, which is free of cost for most individuals, helps cover hospitalization, care in a skilled nursing facility, hospice care, and some home health care.
  • Part B costs about $100 a month and provides coverage for outpatient services such as doctor’s visits, lab tests, preventive care, certain surgeries, clinical trials, mental health care, and durable medical equipment and supplies.
  • Part C, also known as Medicare Advantage, differs in cost and permits people to enroll in Medicare health plans sold by private insurance organizations that contract with Medicare.
  • Part D helps provide coverage for prescription drug costs.

The total sum a Medicare-covered senior may end up paying for his or her health care will be based on various factors, including:

  • The type of care and the frequency of its requirement.
  • The type of Medicare coverage chosen.
  • Whether a doctor agrees to charge the patient the same sum that Medicare will pay for a service.
  • Whether there are other insurance policies to fill gaps in coverage.

Medicaid

Medicaid is a health insurance program run by individual states and somewhat financed by the government. For low-income individuals and senior citizens, it is the insurance they would go for after all other options have run out.

To fit the bill for Medicaid benefits, a qualified senior should have ‘spent down’ the vast majority of their accessible resources. When the financial floor has been reached, Medicaid will pay for the majority of the expenses related to numerous kinds of long-term health care, including nursing home care, skilled care services at home, and hospice care.

A few seniors who meet all requirements for Medicaid are alluded to as ‘dual eligible’ because they may likewise be covered by Medicare. Medicaid rules differ from one state to another and can often be unpredictable and complicated, so it is significant for low-pay seniors to research how their state’s program functions and how to become eligible for benefits.

Private Health Insurance Plan

Private health insurance policies can be bought by people or given by employers. Most employer-sponsored policies end when an individual retires, unless they are part of an employee’s pension or union plan. Therefore, private health insurance provides coverage for a small percentage of seniors.

Moreover, individual private policies can be very costly, as carriers figure out an applicant’s health, age, and other risk factors before issuing coverage. Seniors with critical medical conditions or predispositions can be denied coverage altogether, or they can face exorbitant premiums.

Private insurers also sell Medicare Supplemental Insurance – known as Medigap. These policies cover some costs that Medicare does not. They can also be used to pay for Medicare co-pays and deductibles. Other than that, they also sell long-term care policies that help pay for services that are not covered by health insurance, Medicare, or Medicaid, including home health care, assisted living, hospice care, and nursing homes.

Supplemental Health Insurance for Seniors Called ‘Medigap’

While Medicare gives inclusion to most health care needs, there are still some undeniable gaps that are not covered except if you select Medicare Supplement Insurance, which is commonly known as “Medigap.”

Medigap arrangements help pay out-of-pocket costs for deductibles, co-payments, and coinsurance that Medicare does not. Medigap arrangements are sold by private insurance organizations and are applied after Medicare pays its share of the approved sum for health care costs that are covered.

Medigap policies are not equivalent to the Medicare Advantage Plan, which gives benefits. Medigap policies supplement the benefits in your original Medicare plan. They do not cover long-term care; dental or vision care, eyeglasses, hearing aids, or private-duty nursing. Plans purchased since 2006, are not allowed to cover prescription medication.

Some important things to remember about Medigap:

  • Medigap coverage is paid directly to an insurance company along with the coverage you purchased for Medicare Part B.
  • Medigap coverage should be signed up for in the six months following your 65th birthday. If you do not, you could be denied coverage by insurers because of a pre-existing condition, or you would have to pay a higher premium.
  • Only one person is covered by a Medigap policy. If you and your spouse want Medigap coverage, both of you would have to purchase separate policies.
  • People who have Medicare Part A (cost of hospital services) and Part B (cost for doctor services) are the only ones who have access to Medigap policies.
  • Standard Medigap policies are guaranteed renewable.

Health Care Options for Senior Veterans, Military Retirees, and Their Spouses

A senior veteran of any branch of the military who was respectably discharged may meet all requirements for health benefits supported by the Veterans Administration (VA). The VA’s health care system covers all veterans, despite their age, who have served for at least two years of constant active duty, have a service-related disability, or have served in various wars.

Furthermore, under the CHAMPVA program (Civilian Health and Medical Program of the Department of Veterans Affairs), qualified recipients, including elderly spouses or widows of certain disabled or deceased veterans, may likewise get federally sponsored health insurance.

Presently, there are more than 9.3 million veterans who are older than 65 and are qualified for both Medicare and VA-sponsored health care. These veterans and their certified dependents can utilize their VA benefits to supplement inclusion under their Medicare policies.

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The Department of Defense’s (DoD) Military Health System gives health care under its TRICARE program for active duty service members and their families, along with retired military people of all uniformed branches who have finished at least 20 years of service.

Qualified, retired military staff who are enrolled in Medicare Parts A and B can apply for the DoD’s TRICARE for Life (TFL) program, which, similar to private Medigap insurance, pays for sure out-of-pocket clinical costs not covered by Medicare Part B.

Assisted Living

Assisted living is a long-term health care choice intended for people who need help with everyday tasks and exercises, like suppers, washing, and dressing, medication management, and so forth. As of now, there are over 30,200 professionally managed assisted living networks in the United States, lodging more than 835,000 individuals.

Assisted living expenses can generally differ based upon numerous variables, including the size of the condo and the types of services offered. In 2018, the median monthly rate across the country at an assisted living center was $4,000.

More than 86 % of assisted living inhabitants pay for their lease and services through private, long-term care insurance or from their own savings, as assisted living is not a service commonly covered under Medicare. In any case, 41 states have waiver programs for low-pay seniors to assist them with bearing the cost of this option.

Nursing Homes

Nursing homes give recuperating or potentially rehabilitative care for people with constant health conditions or after an emergency stay at the hospital. The degree of care can go from basic to skilled, and then from skilled to sub-acute. Unlike assisted living, a doctor’s order is needed for admission to a nursing home.

Nursing homes are authorized and directed at the state level. Care should be given by registered nurses (RNs) or licensed practical nurses (LPNs). Intermediate care facilities (ICFs) give at least eight hours of nursing supervision daily, and skilled nursing facilities (SNFs) offer clinical services 24 hours every day.

In 2018, the median monthly cost of a semi-private nursing home stay in the United States was $7,441. The cost of a private nursing home was $8,365. Expenses can be paid for out of private assets, long-term care insurance policies, and also Medicare and Medicaid.

Hospice and End-Of-Life Medical Care

In the course of the past few decades, more end-of-life care choices have been offered by hospice organizations and projects.

Hospice care is for anybody diagnosed with a terminal sickness who has exhausted all curative medical care and has six months or less to live. It could be given at a person’s home, a hospital, a hospice center, or a nursing home. Notwithstanding palliative care, hospice incorporates emotional and spiritual help for patients and their families.

Medicare is the essential payer for over 80% of hospice patients in the country. It covers 100% of medications and fundamental clinical supplies utilized during hospice care. Hospice can likewise be covered under private insurance, employer-sponsored approaches, and through programs of the Veterans Administration and the Department of Defense.

Additional Senior Health Care Options

The Partnership for Long-Term Care is a program accessible in 43 states that joins private long-term care insurance and Medicaid long-term care inclusion. The partnership helps expected users of Medicaid hold a greater amount of their resources while still being qualified for inclusion.

The Program of All-Inclusive Care for the Elderly (PACE) gives coordinated Medicare and Medicaid benefits for seniors who wish to keep getting clinical, social, and long-term care in their own homes instead of in a nursing home. It is accessible in 28 states.

Can I get Health Insurance if I am over 65?

If you are more than 65 years old but not qualified for Medicare, you are still qualified to get inclusion on the exchange. On the off chance that you meet the requirements dependent on pay and family size, you are qualified for cost-saving subsidies, as well.  If you have the health benefits for a retired person, you are considered to be covered under the ACA and will not be penalized. You can replace that inclusion with other coverage. Notwithstanding, if your retirement inclusion is considered to be reasonable and satisfies certain base guidelines, or on the off chance that you are qualified for Medicare but have decided not to enroll, you will not be eligible for cost-saving subsidies. Keep in mind that if you are more than 65 years old, the fee for not having inclusion still applies.

COVID-19 Insurance for Senior Citizens

Older citizens of the United States have been among the first people to get the COVID-19 vaccination. This has given them the certainty to go out and to travel after being locked inside bubble environments for all of 2020. In any case, given that the pandemic is not completely over (or even under control), it is vital to purchase legitimate travel medical insurance which also covers COVID-19 while traveling outside the US. Global travel has been very difficult during the pandemic. This is especially so for older travelers. Given the health hazards and increased healthcare costs during the pandemic, it is vital to have travel medical insurance abroad (which covers COVID-19 sickness) for people who are more than 65 years old.

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Travelers can contrast holiday insurance for beneficiaries and COVID-19 inclusion by utilizing a seniors travel insurance comparison tool. Travelers ought to give significant data like their age, the duration of travel, the maximum medical inclusion, the deductible, and the COVID-19 travel insurance inclusion prerequisite. You can filter the accessible clinical insurance for senior citizen’s plans with alternatives for the inclusion of COVID-19 sickness. The traveler would then be able to go through these senior citizen corona insurance inclusion plans dependent on cost and other benefits and purchase COVID-19 insurance that they like best.

The 5 Best Health Insurance for Senior Citizens in 2021

UnitedHealthcare

If you are looking for a good overall insurance provider for retirees, then UnitedHealthcare is the best option because of its comprehensive coverage options that surpass the limits of Medicare. With UnitedHealthcare, you can get global coverage and vision, dental, and chiropractic care.

Even though Medicare is a valuable insurance option, it does come with its limitations. Prescription drug coverage, medical care received outside the United States, or dental or vision care is not included in Medicare. If you want coverage for these services, you can go for a Medicare Advantage Plan, also known as Medicare Part C. UnitedHealthcare is the biggest provider of Medicare Advantage Plans, with 26% of Medicare Advantage beneficiaries enrolled in the organization’s plans. It also has an A (Excellent) rating from AM Best.

Moreover, both HMO and PPO plans are offered by UnitedHealthcare. Therefore, you can choose a provider network that meets your requirements. With a Medicare Advantage Plan from the company, you get coverage when traveling outside the United States. On top of that, vaccinations and preventative care are completely covered at no extra cost. Based on your location and the policy you opt for, UnitedHealthcare plans may cover services such as:

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  • Caregiver resources
  • Chiropractic visits
  • Dental care
  • Fitness club memberships
  • Hearing aids
  • Meals
  • Medical transportation
  • Vision care

Medicare Advantage Plans are only accessible to individuals who are eligible for Medicare. You may have to pay an extra premium for your plan based on the policy and deductible you choose. Some Medicare Advantage Plans have regional limitations, so make sure that you double-check your policy if you spend months out of the year in a different location, for instance, spending the winter in the southern states.

If you are qualified for Medicare, enrolling in a Medicare Advantage Plan from UnitedHealthcare is a great way to ensure you have a complete health insurance plan that goes past Original Medicare’s covered services. UnitedHealthcare has robust coverage options, expansive provider networks, and extra-covered services.

Pros

  • Additional services are covered
  • Vaccinations and preventative services are 100% covered
  • You have coverage when traveling outside the country

Cons

  • Additional premium required
  • Only accessible to those eligible for Medicare
  • There may be location limitations

Humana

If you have coverage through Medicare, the best supplemental policy is Humana. Humana’s Medicare Supplement Plans — otherwise called Medigap — help pay for your remaining health care costs, and plans may likewise cover additional services like traveling abroad or your nursing care coinsurance.

In case you are 65 years old or more, you may not think that you need extra coverage since you meet all requirements for Medicare. Notwithstanding, Medicare is not free healthcare. Truth be told, a 65-year-old couple that retired in 2019 can expect to pay $285,000 in healthcare and clinical costs during their retirement. A Medigap policy can help cover your health costs, like your Medicare deductibles, coinsurance, or co-payments.

Humana is one of the top Medigap suppliers, offering an easy-to-understand website that permits you to easily look through the company’s Medigap plans. With a Humana Medigap policy, you can see any healthcare supplier you wish that accepts Medicare, without worrying over networks. Contingent upon which plan you pick, most of your Medicare costs might be covered. Humana has an A (Excellent) rating from AM Best. Nevertheless, Medigap arrangements exclude prescription drug coverage, and your monthly premium might be costly.

Humana is not authorized to offer Medigap policies in all states, so verify whether plans are accessible in the state where you reside. Humana is the best Medigap supplier due to its adjustable coverage alternatives and the ability to keep the healthcare suppliers you trust.

Pros

  • Multiple plans to choose from
  • The majority of your Medicare costs are covered
  • You can choose any healthcare provider

Cons

  • Does not include prescription drug coverage
  • Monthly premiums can be high
  • Not available in all locations

Medicaid

On the off chance that you are a low-pay senior, the most ideal approach to get health insurance is through Medicaid, a government insurance program. With Medicaid, you can get free or low-cost coverage. Medicaid is a federal program for low-pay people and individuals with disabilities. It gives coverage to 7.2 million seniors who are likewise enrolled in Medicare.

Through Medicaid, qualified recipients can get monetary help with their Medicare premiums and out-of-pocket clinical costs. It additionally covers benefits that Medicare does not, like prescription drugs, eyeglasses, and hearing aids. In the event that you have a health-related crisis, for example, a severe sickness, Medicaid gives fundamental protection.

In any case, not every person is eligible for Medicaid. To be qualified, you should meet your state’s income limitations. Regularly, you need to earn not more than 200% of the federal poverty level in addition to an extra $20 to fit the bill for Medicaid assistance.

A few states will provide coverage for grown-ups who are not yet qualified for Medicare through Medicaid. However, not all states do. On the off chance that you live in a state that has not extended its Medicare coverage, you may not be eligible for help until you reach 65 years of age. For low-income people, Medicaid is the best health insurance choice. You can get comprehensive coverage and may pay as low as $0 each month.

Pros

  • Covers services that Medicare doesn’t
  • Low or $0 premiums for low-income seniors
  • Provides a financial safeguard

Cons

  • Income restrictions apply
  • Some states have cost-sharing programs
  • You may not qualify if you’re under 65

Golden Rule Insurance Company.

The best choice for short-term insurance for retirees is the Golden Rule Insurance Company. It offers low monthly premiums and is ideal for individuals who retire early and want to bridge the gap until they are qualified for Medicare. If you retire before turning 65, short-term insurance can provide some protection until you are qualified for Medicare.

UnitedHealthcare backs The Golden Rule Insurance Company, which has an A rating from AM Best and specializes in short-term insurance policies. With a short-term policy from the organization, you can get health insurance to protect against emergencies at a cost that is significantly affordable than private insurance.

Golden Rule Insurance Company has plans accessible for just $38 each month. Likewise, you do not need to wait for your coverage to start; it will begin early as the day after you buy your policy. You can enroll in a short-term plan whenever you want, without having to wait for a yearly Open Enrollment period or fitting the bill for Special Enrollment.

In any case, the Golden Rule Insurance Company can deny you for pre-existing conditions, and short-term plans do not need to cover all the same advantages that private insurance does. While a federal mandate for minimum essential coverage does not exist anymore, a few states still have mandates. Momentary plans do not ordinarily fulfill the minimum essential coverage prerequisite, so you may owe a penalty when you settle your state taxes.

If you have one to three years until you are qualified for Medicare, buying a short-term insurance plan from the Golden Rule Insurance Company can give you coverage during seasons of progress. It is the top choice for short-term insurance since it is supported by UnitedHealthcare, one of the biggest and most dependable insurance organizations in the country. What’s more is that plans are reasonably priced, costing a lot less than other insurance plans for retirees.

Pros

  • Coverage can start as quickly as the next day
  • Low monthly premiums
  • You can enroll at any time

Cons

  • Coverage may not cover some necessary services
  • Short-term coverage may not satisfy state-level requirements
  • You can be denied for pre-existing conditions

Cigna

If you plan on buying private insurance through the Health Insurance Marketplace, Cigna is the best decision. You can get comprehensive coverage, regardless of whether you have pre-existing conditions, and Cigna offers advantages like $0 virtual care with 24/7 access to doctors and nurses. It is one of the biggest insurance organizations on the Health Insurance Marketplace, with more than $32 billion in premiums written in 2019. When looking at plans on the Health Insurance Marketplace, Cigna stands apart from its rivals with its additional perks and advantages.

Cigna members get $0 virtual care, where you can get in touch with a specialist through telephone or video call with no extra out-of-pocket expense. Notwithstanding what sort of supplier you pick, you need not bother with referrals to see a specialist, however, your primary care physician can suggest a specialist to you that is within the network to help you save up some cash. In case you are diabetic, you will almost $25 out-of-pocket for a 30-day supply of covered insulin. Also, Cigna’s diabetes care plans offer extra advantages with $0 out-of-pocket expenses.

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Cigna additionally offers separate worldwide coverage. If you regularly travel outside the country, you can buy international insurance to ensure you are covered. It additionally has data about financial assistance options accessible to its clients. Notwithstanding, not every person will meet all requirements for sponsored premiums, so you might be responsible for the full expense yourself.

While Cigna’s group and dental plans are accessible all through the country, full coverage plans bought through the Health Insurance Marketplace are not accessible in all states. In 2021, Cigna is only accessible in Arizona, Colorado, Florida, Illinois, Kansas, Missouri, North Carolina, Tennessee, Utah, and Virginia.

Cigna is the most ideal decision for individuals who are younger than 65 on account of its comprehensive coverage alternatives for individuals with pre-existing conditions. As a retired person, you can appreciate added benefits as a Cigna client, and can even qualify for cost-saving projects.

Pros

  • $0 virtual visits with doctors
  • Financial assistance programs available
  • No referrals needed for specialists

Cons

  • Does not offer plans in all states
  • International coverage must be purchased separately
  • Not everyone will qualify for subsidized premiums

Conclusion

Seniors who need more savings are compelled to manage medical debt. However, the greater part of senior health care is not paid for by seniors but rather by private insurance providers and federal programs like Medicare, Medicaid, and the Veterans Administration. These private and public projects pay for the vast majority of the doctors, hospitals, assisted living centers, nursing homes, prescription medications, and end-of-life care used by America’s around 40.3 million seniors, who make up 13.4 % of the populace.

Charles Bains

Charles Bains

Charles Bains started his insurance career as a marketing intern before pounding the pavement as a commercial lines agent in Orlando, FL. As an industry journalist, his articles have appeared in a variety of trade publications. His insurance television career, short-lived but glorious, once saw him serve as the expert adviser on an insurance-themed infomercial (yes, you read that correctly). Having recently worked for various organizations, coupled with his broader insurance knowledge, Charles is able to understand our client’s needs and guide them accordingly. He is a gem for Insurance Noon as his wide area of expertise and experience have been beneficial in conducting further researches to come up with solutions and writing them in a manner which is easy for everyone including beginners to comprehend.

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