Almost everyone is conscious of the fact that Medicare Parts A and B are almost as holy as a honeycomb. But how does one cover those gaps effectively without breaking the bank? Thankfully, there are insurances for the sole purpose of providing in those instances. Medicare Advantage and Medigap policies. As a Massachusetts senior, there are surely plenty of questions you have about the topic of insurance.
Senior Medicare in Massachusetts: Facts and Figures
- There are 76,404 senior citizens living in Boston right now
- There 11 hospitals in the Boston, MA area where seniors can get emergency and/or in-patient care
- 21% of MA seniors have a Medicare Advantage plan
- 20% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 59% of seniors potentially uninsured or underinsured against costly Medicare coverage gaps!
It is a sad truth that chronic ailments become more pervasive with age. It is simply what happens as the human body begins to cease functioning as well as it once did. Usually, these are the diseases which we carry for the rest of our lives, as well as the costs associated with them. As if that wasn’t difficult enough to handle, it is not just possible but likely that we may have more than one disease at a time. This could lead to outlandish medical expenses that could cripple even the most financially sound senior, if they are under- or uninsured. The chart below details the common chronic diseases among seniors in Boston.
|Disease||Prevalence (in Boston)|
|High Blood Pressure||26%|
|Coronary Heart Disease||5%|
Healthcare Costs in Boston, MA
We cannot talk about chronic disease without talking about money. Medicine, equipment, hospital care, doctor’s visits; they all add up quickly. And they keep adding up as more time goes on. Seniors are living longer lives than ever, which is fantastic. But that quality of life quickly diminishes when crushed under the weight of unending medical debt. Now is more important than ever to ensure you have adequate protection for the next phase of your life. Affordable, comprehensive, helpful healthcare coverage is the most important preparation.
|Disease||Prevalence (in Boston)||Annual Cost of Treatment|
|High Blood Pressure||26%||$356|
|Coronary Heart Disease||5%||$8,705|
Medicare Advantage Savings in Boston, MA
The federal government has approved Medicare Advantage, which is a non-government administered private health insurance plan. The costs of your individual insurance are not directly paid for by the government, but instead the government pays their share towards your monthly premium and you pay the remaining medical costs on your own. Legally, your insurance must cover at least the identical benefits you would get if on state-mandated Medicare Parts A & B. Most non-government insurers add additional benefits like vision or dental, for a premium.
Seniors who enroll in Medicare Advantage feel that they have better coverage, particularly for chronic illnesses. Common ailments for seniors – like arthritis, diabetes, and high blood pressure – are difficult to manage at best. They can necessitate medications, testing supplies, more visits to the doctor, and a plethora of additional unforeseeable costs. As these conditions gradually get worse, the cost continues to go up. Some Medicare Advantage plans can offer much more thorough coverage than Medicare alone, even with a Part D drug plan. Even with insurance plans and supplements, it isn’t a bad idea to save now, to be better prepared for later.
Medicare Advantage plans cover every bit as much as Medicare Parts A and B, and then even more. They can include all of those doctor visits and pieces of equipment, as well as potentially a plan for necessary drugs. A majority of the offered plans are presented with an option to include any combination of the variety of expenses – even dental or vision. Since the government pays a portion of the Medicare Advantage premium, many seniors can enjoy an additional monthly premium starting as low as $0. Coinsurance and copays will still be patient responsibilities, as well as out-of-pocket costs, but they will be significantly reduced.
Medicare Supplement (Medigap) Savings in Boston, MA
Additional Medicare gap coverage policies are Medicare Supplement Insurance policies, or Medigap policies. They work a bit differently than Medicare Advantage plans, but can still save a good amount of money, particularly with gaps in Medicare Part A. Severe chronic conditions can cost five digits and up for a single treatment or incident. At a given point, Medicare stops their coverage, and the patient is responsible for the rest. These bills can be huge, and make an already difficult diagnosis and treatment that much harder.
Medigap Plans A, D, K, and L are the ones designed to cover the pricey costs for the lack of coverage in Medicare Part A. The other Medigap plans have Part A coverage as well, but include extras that we’ll touch on in a minute. If Medicare Part B costs aren’t something you need, you then shouldn’t feel the need to purchase them, thus saving you more premium. If hospital stays from Part A is your concern, Plans A, D, K, and L are the ones you may wish to consider first.
Medigap Plans B, C, D, F, G, M, and N, are all created to cover the gaps in both Medicare Part A as well as various other aspects of Medicare Part B. The more thorough the coverage in your plan, the higher the premium is likely to be. But, this also means that you will likely have much less out-of-pocket costs, so it still could save you money in the long run. It all depends on your specific insurance product needs. Be certain to note that Plan F is set to retire in 2020, and will not be offered any longer as of 2021.
Medicare part B plans are supposed to take care of aspects that Part A does not, namely outpatient procedures, General Practitioner and Specialist visits, and some select pieces of medical equipment. Co-pays, coinsurance, and premiums for original Medicare part B can be difficult, however. There are many options to reduce this cost and help from the expenses getting overwhelming.
Medicare supplement insurance does not provide for Rx drugs, dental, or vision, unlike Medicare Advantage. However, Original Medicare does allow seniors to choose a Part D, which provides for prescription drugs and the associated costs. This is offered whether or not you choose a Medicare supplement insurance plan. With a little research, it is easy to find affordable dental and vision plans for seniors in your area. Discounts for the elderly are especially available in most locations.
For all seniors in Boston, it is of the utmost importance that you understand the principles and advantages of a supplemental Medicare health plan. These can be the difference between living through your golden years or having them rust and turn to bronze years. The rising cost of medicine and care is out of control, but what we can control is how we prepare to face the inevitable. You absolutely have to find a Medicare supplement policy that fits your needs, yet doesn’t break the bank. We want to help you do exactly that.
|Medigap Plan||Minimum Monthly Premium||Maximum Monthly Premium||Average Estimated Monthly Premium (Part B Premium Included)|
|Medigap Core Plan||$94||$171||$268|
|Medigap Supplement 1 Plan||$169||$257||$349|