Sparks, Nevada is dry, peaceful, and has a vibrant retirement community with just about all of the amenities that a senior could ask for. Unfortunately, if you rely on Original Medicare to help you meet your healthcare needs, you will most likely not always have access to the disposable income necessary to fully enjoy your retirement. Instead, you’ll be spending that money on Medicare coverage gaps. Medicare coverage gaps are certain treatments and services which are not covered by Medicare, and will cost you thousands in out-of-pocket medical bills if you aren’t properly insured. In order to avoid these coverage gaps, more and more seniors in Sparks are are switching to Medicare Advantage and Medicare Supplement (a.k.a. Medigap) insurance plans.
Facts and Figures
- There are 15,324 seniors living in Sparks right now.
- There are 6 hospitals in the Sparks area where seniors can get emergency and/or in-patient care.
- 35% of Nevada seniors have a Medicare Advantage plan.
- 13% of Nevada seniors have a Medicare Supplement (Medigap) plan.
- Which leaves 52% of seniors potentially uninsured or underinsured against costly Medicare coverage gaps!
Just under half of all seniors in the Sparks area have reliable access to affordable healthcare. For the estimated 7,968 other seniors in the area, however, the same cannot be said. If you rely on Original Medicare, then coverage gaps and the related out-of-pocket expenses are only going to worsen as you age. That’s because of the direct relationship between age and age-related illnesses. Age-related illnesses bring with them a wide array of new symptoms and further increase the likelihood that your existing symptoms will worsen in both frequency and severity. The chart below demonstrates the prevalence of each of the five most common age-related illnesses in the Sparks area.
|Disease||Prevalence in Sparks, NV|
|High Blood Pressure||27%|
|Coronary Heart Disease||6%|
Healthcare Costs in Sparks, NV
As you develop new or worsening symptoms, your need for healthcare increases. Since you’ll be seeing the doctor more often and using your benefits with greater frequency, your likelihood of landing in the Medicare coverage gaps increases as well. Even if your symptoms do not change from year to year, your healthcare costs likely will. There are a variety of reasons why, but the most important is that medical costs are rising across the board, meaning that a treatment that may have cost you only $100 this year might cost you $150 or even more next year. Since seniors are living longer lives than ever before, there will also be more time throughout your life for these economic factors to add up. As the chart below shows, you could end up paying thousands of dollars in out-of-pocket expenses every year, per illness.
|Disease||Prevalence in Sparks, NV||Annual Cost of Treatment|
|High Blood Pressure||27%||$356|
|Coronary Heart Disease||6%||$11,974|
Medicare Advantage Savings in Sparks, NV
Medicare Advantage plans are private insurance plans that entirely replace your existing Medicare coverage plan. That means that your new insurer will be listed as a private company rather than the United States government. Of course, that doesn’t mean that the government won’t still play a hand in controlling what gets covered. The government mandates that all Medicare Advantage plans provide the same level of care and coverage as Original Medicare, but that’s only the minimum. Many providers of Medicare Advantage plans will go above and beyond that, offering additional coverage options in exchange for you paying higher premiums. That being said, the government tends to take care of all or most of your premiums, meaning that you might not actually have to pay any more than $0 each payment period.
One of the most notable additional coverage options is Medicare Advantage prescription drug coverage. Although the exact specifics of which medications receive coverage varies from provider to provider, the general rule of thumb is that these plans are so comprehensive as to cover just about every one of your prescription needs. Moreover, they can even be expanded to cover necessary medical equipment like glucose monitors and testing strips. If you happen to have been diagnosed with arthritis, high blood pressure, and/or diabetes, one of these plans could potentially help you save tens of thousands of dollars over the ten-year period. See the graph below for more information.
Medicare Advantage plans also enable you to add vision and dental care coverage directly to your plan, which is something that neither Original Medicare nor Medicare Supplement insurance allows. While on either of those other two plans, you will have to search elsewhere for both vision and dental care. Not to mention that the vision and dental benefits provided by Original Medicare and Medicare Supplement insurance combined still pale in comparison to the benefits provided by Medicare Advantage vision and dental care coverage.
Medicare Supplement (Medigap) Savings in Sparks, NV
Unlike Medicare Advantage, Medicare Supplement plans do not replace your Original Medicare plan. Instead, they simply supplement it, as the name suggests. These plans are also known as Medigap plans, a name derived from their function. All in all, there are ten different plans from which to choose (A, B, C, D, F, G, K, L, M, and N) and each one provides different benefits. That being said, many plans do have quite a few common features. For example, every one of the ten available plans provides some form of protection against coverage gaps related to Medicare Part A expenses, making these plans particularly useful for seniors suffering from age-related heart and/or kidney disease. To better help you understand what it is that these plans do, we have broken down the ten available plan types into two separate categories.
The first category of Medicare Supplement plan types includes Medigap plans of types A, D, K, and L. These plan types provide substantial financial assistance related to Medicare Part A coverage gaps, which enables you to receive worry-free access to treatments such as hospitalizations, blood transfusions, and skilled nursing care. That being said, these plan types only provide assistance with Medicare Part A coverage gaps. If you are also or are only paying Medicare Part B coverage gaps, you won’t find much help in one of these plan types.
The second category of Medicare Supplement plan types includes Medigap plans of types B, C, F, G, M, and N. These plan types provide substantial financial assistance related to Medicare Part A coverage gaps as well as Medicare Part B coverage gaps, which enables you to receive worry-free access to the aforementioned treatments as well as most emergency services and yet more options. If you have been paying out-of-pocket to receive treatment related to both Medicare Part A and Medicare Part B or only Medicare Part B, then these plan types might be the best option for you. However, it is important to keep in mind that not all of them are going to last forever. For example, Medigap Plan F is only going to be available through the end of 2020 for new Medicare enrollees. Once 2021 rolls around, that will be the end of Medigap Plan F for most seniors.
As mentioned earlier in this article, the only plan that enables you to add vision and dental insurance directly to your plan is Medicare Advantage. The same goes for prescription drug coverage. In order to obtain either of these three coverage options, you have to jump through a couple small hoops. For vision and dental coverage, you can go online to an insurance provider’s website who services the Sparks area. From there, simply select the coverage options that you need and then enroll in the plan. Since vision and dental plans are not subject to the same rules and regulations concerning open-enrollment periods as health insurance are, you can do this at any time. For prescription drug coverage, you can simply enroll in Medicare Part D prescription drug coverage. Although this plan does tend to risk you falling into the “donut hole,” another coverage gap, many seniors believe that it is a great alternative to Medicare Advantage prescription drug coverage.
As medical costs continue to rise and you begin to develop new or worsening symptoms, you need to take the proper steps to ensure that you stay insured. That means protecting yourself not only against adverse health conditions but also against the costly out-of-pocket expenses associated with Original Medicare’s coverage gaps. Although you can wait on insurance, you can’t wait on age. Every year you put off enrolling in either a Medicare Advantage or Medicare Supplement Insurance plan is another year that you risk paying thousands of dollars in out-of-pocket expenses as a result of the Medicare coverage gaps. So don’t wait! Head over to Medigap.com today and get started shopping for a plan that is right for you.
|Medigap Plan||Minimum Monthly Premium||Maximum Monthly Premium||Average Estimated Monthly Premium (Part B Premium Included)|
|Plan F (high deductible)||$28||$80||$190|