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Senior Health Insurance

Among those who need reliable insurance are senior citizens.  Hospital bills, prescription medicines, and general medical expenses are more prominent among this age group, and coverage is important, as those costs can add up.  One very popular option for senior health care is Medicare, a widely used plan for medical coverage that covers hospital stays, the cost of prescription drugs, and other medical needs that may be faced by the consumer that holds the policy. 

 

Senior Health Insurance:  What is Medicare?

The requirements for Medicare eligibility are anyone over the age of 65, those under 65 who have disabilities, and anyone who has end-stage renal disease and is being regularly treated for the disease.  So-called original Medicare is the program that everyone who enrolls in Medicare is initially put in.  It is federally funded, not privately funded, and has lower premiums for the consumer to pay. 

Advantage Medicare is one of the types of health insurance funded privately and has more coverage than original Medicare.  Privately funded Medicare is controlled by private insurance companies, and the premiums can be higher for private Medicare.  However, as with any other insurance, higher premiums can mean better coverage, although any “extras” will lead to higher premiums as well.  Federally funded Medicare is limited in its coverage, so it may be preferable for someone who needs Medicare to add supplemental coverage to federal Medicare, or purchase a private funded Medicare plan.  Extra coverage can be more expensive, however, and supplemental coverage may not always be reliable or as inexpensive.    

 

Senior Health Insurance:  What are the policies?

For a health expense to be covered by Medicare, the medical facility must also be covered by Medicare.  The consumer must then find a facility that will be covered by Medicare, and sometimes this could require switching a doctor that one has visited for years in order to be covered by insurance.  If the consumer is willing to do this, it will not be a problem, but some consumers would not wish to switch doctors and visit a stranger, an understandable dilemma that anyone can face. 

Deductibles must be paid before Medicare will help out with the rest of the expenses, and Medicare is careful to notify policy owners of any expenses or bills that need to be paid.  These are sent to the policy owner with a Medicare Summary Notice.  These notices also tell the consumer if he is able to get a check for payment, which is not always the case, but sometimes a consumer can get a check, depending on his situation or eligibility.  Another thing to know is that rates for Medicare change in January of every year so the consumer must make sure that they know what any new rates are so that they are not surprised by changes in how much they must pay in premiums.

There are, of course, medical expenses that will not be covered by Medicare, and some companies will send someone an Advanced Beneficiary Notice for him to sign and agree to pay expenses that Medicare cannot cover.  If a consumer does not wish to sign, then he may decline to pay, but he must know that he is also declining for a procedure to be performed, which may not be desirable in some medical cases. 

 

Senior Health Insurance:  Final Advice

Consumers looking into purchasing Medicare must do as much research as they can, as with any other insurance that they might be interested in.  Original Medicare, which is the Medicare that consumers are automatically enrolled in when getting Medicare, is more limited than a consumer may desire.  If possible, it can be supplemented and should be, provided that the consumer wishes to stick with the original Medicare plan that he is enrolled in.  A consumer must make sure that he does his research so that he knows everything that goes on in his health insurance coverage. 

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