Life is great in Durham, North Carolina! The people are friendly, crime is low relative to the surrounding areas, and the culture is great. But what about medical care? Unfortunately, for people aged 65 and older, access to healthcare isn’t one of Durham’s strong suits. There are thousands of seniors who don’t have the proper healthcare insurance, leaving them either spending massive sums of money on Medicare coverage gap expenditures or going without healthcare because the government has cut them off. Let’s take a quick look at the numbers to see exactly how many seniors that this applies to.

Facts and Figures

  • There are currently 29,623 seniors residing in Durham, NC.
  • There are 10 hospitals for seniors in the Durham area to receive emergency and/or in-patient care.
  • 32% of all North Carolina seniors have a Medicare Advantage plan.
  • 25% of all North Carolina seniors have a Medicare Supplement (Medigap) plan.
  • That leaves 43% of seniors in Durham, NC potentially uninsured or underinsured against costly Medicare coverage gaps!

These numbers mean that there are a total of roughly 12,738 seniors who are stuck with having to deal with the unwarranted expenses of Medicare coverage gaps. Either these seniors are paying massive amounts of cash out-of-pocket in private premiums or they’re electing to go without the healthcare that they both need and deserve. This might not seem like much of a concern at first – after all, these seniors might simply be healthier than the other 57% – however, the prevalence of many chronic illnesses increases with age. The chart below details a few of the most common diseases among seniors in Durham, NC. Of course, it is important to keep in mind that many seniors can potentially be diagnosed with more than one of these illnesses, further increasing the need for proper healthcare coverage. Take a look for yourself:

Disease Prevalence in Durham, NC
Arthritis 19%
High Blood Pressure 31%
Coronary Heart Disease 5%
Diabetes 10%
Kidney Disease 3%

Healthcare Costs in Durham, NC

Each of the diseases listed above are what healthcare professionals refer to as “age-related illnesses.” What this means is that each of these illnesses become more and more prevalent as your age increases. Furthermore, the increase in prevalence also strongly correlates with an increase in the frequency and severity of symptoms. For example, when you’re 65, arthritis might manifest in a way that simply makes your joints sore after a few minutes of walking. However, by age 70, it is entirely possible that this age-related illness will have increased in severity to the point where you can no longer stand without assistance and you need constant medical treatment in order to so much as hold the TV remote. Furthermore, seniors are living much longer lives than ever before, meaning that these illnesses can increase in frequency and severity over longer periods of time, leading to larger costs of treatment each subsequent year. Below are a few of the lower annual estimates.

Disease Prevalence in Durham, NC Annual Cost of Treatment
Arthritis 19% $280
High Blood Pressure 31% $288
Coronary Heart Disease 5% $7,493
Diabetes 10% $2,158
Kidney Disease 3% $6,907

Medicare Advantage Savings in Durham, NC

Medicare Advantage enables seniors like yourself to save considerable amounts of money each year. With Original Medicare, it is possible to spend “too much” money on ensuring your survival, at which point the government will “cut you off,” denying you the benefits that you have spent your entire life paying into. This is what is known as the Medicare coverage gap. Medicare Advantage insurance is actually not controlled by the government. Rather, it is privately owned and operated. These plans are still required by law to cover all of the basics of Medicare but they also typically allow you to “spend a little more” to add improved benefits at a cost of a whopping zero dollars in premiums each month for certain qualifying seniors.

This reduction in premiums and increase in total coverage benefits can also be extended to more areas than simply the primary medical focuses. Medicare Advantage plans can cover Medicare Part A and Medicare B expenses as well as prescription drug coverage and dental and vision care. Medicare Advantage can even cover the minor necessities such as glucose monitors and testing strips. This makes Medicare Advantage insurance a far more comprehensive option than Medicare Supplement (Medigap) plans, even if the former do cost nominally more than the latter. At the end of the day, however, the savings speak for themselves. By enrolling in a Medicare Advantage plan, you can stand to save thousands of dollars over the five-year term and tens of thousands of dollars over then ten-year term.

Vision and dental coverage are two of the most notable differences between Original Medicare and Medicare Supplement (Medigap) insurance plans. While Medicare Advantage providers almost unanimously provide options for vision and dental insurance with various coverage benefits, neither Original Medicare nor Medigap can provide such benefits. With Original Medicare, you will still run the risk of falling into the Medicare coverage gap; and, with Medigap insurance, you will not have the option of adding either vision or dental coverage to your plan whatsoever. However, there are ways around that, which we will cover in greater detail in the next section, immediately following this chart that demonstrates the low quotes from top Medicare Advantage providers.

Medicare Supplement (Medigap) Savings in Durham, NC

Medicare Supplement (Medigap) insurance plans can also serve to save you quite a bit of money on out-of-pocket Medicare coverage gap expenditures. These plans, while not typically as comprehensive as Medicare Advantage plans, still come with quite an array of potential coverage benefits. In fact, Medigap plans tend to focus primarily on improving your ease of access to hospital and other in-patient medical services, including emergency room visits. These Medicare Part A expenses are exceptionally high for seniors with chronic health concerns, such as chronic heart disease and chronic liver disease, making Medigap plans perfect options for such people. There are such a wide variety of plans and policies out there, so it is important to speak with a Medigap expert to find out which one is right for you before taking an unnecessary risk with your hard-earned nest egg. We’ll explain the primary ten below.

First things first, we have Medicare Supplement insurance Plans A, D, K, and L. Like the other six Medigap plans, these are supplemental insurance plans, meaning that you would not have to sacrifice your Original Medicare benefits in order to purchase one of these plan types. Unfortunately, these four plan types only cover Medicare Part A expenses. While this might be all you need if you find that your kidney or heart disease is causing you to spend a lot of time and money on in-patient care and not much on any other aspect of your health, that doesn’t tend to be the case for most people.

The other six plans are Medicare Supplement insurance Plans B, C, D, F, G, M, and N. When it comes to Medicare Part A expenses, these plans can be either quite similar or somewhat different from plans of type A, D, K, and L. However, the primary difference can be seen in the fact that these six plans each also cover expenses related to Medicare Part B, making each of them potentially great options for seniors who would otherwise be spending large amounts of money on out-of-pocket expenses to receive healthcare while in the coverage gap of both Parts A and B. Unfortunately, Medigap Plan F will no longer be offered beginning 2021. If you currently have a Medigap Plan F or are considering enrolling in one, you might find more benefit to be found in enrolling in either B, C, D, G, M, or N.

The primary drawback of these otherwise great plans tends to be the fact that Medicare Supplement insurance plans do not offer prescription drug coverage or vision or dental care. This means that each of these sections could continue to go uncovered by Original Medicare, with you paying out-of-pocket for each pill or visit to your dentist or optometrist. On the bright side, there may be private plans in your area that can cover your prescription drugs, vision, and dental care for a relatively affordable cost. While this means you would have to deal with the stress of having multiple insurance providers, the extra work would more than pay off in the long run.

When it comes down to brass tacks, your healthcare is your responsibility. Nobody likes to see their independence dwindle away as they’re forced to rely on their children and grandchildren for support. Fortunately, you don’t have to. Thanks to advances in modern technology and new economic developments, there are ways for you to take back control over your healthcare without derailing your financial future. Head over and start shopping for rates today.

Your healthy future self will thank you.

Medigap Plan Minimum Monthly Premium Maximum Monthly Premium Average Estimated Monthly Premium (Part B Premium Included)
Plan A $79 $218 $284
Plan B $114 $249 $317
Plan C $135 $283 $345
Plan D $119 $214 $302
Plan F $127 $283 $341
Plan F (high deductible) $26 $80 $189
Plan G $94 $209 $287
Plan K $47 $97 $208
Plan L $77 $136 $242
Plan M $104 $157 $266
Plan N $84 $218 $287
by Lindsay Malzone, Lindsay Malzone is the Medicare expert for She's been contributing to many well-known publications as an industry expert since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.