Extreme gaps in insurance coverage under Medicare Parts A and B are nothing new. But what can patients, especially seniors, do about it? With the more aged among the population, these sorts of battles aren’t just for surplus change. They can mean the difference between life and death. As a resident of Georgia, you face some uncommon challenges that most other seniors may not when it comes to choosing the most cost-effective health care for you.
Senior Medicare in Atlanta: Facts and Figures
- There are 56,278 senior citizens living in Atlanta right now
- There 10 hospitals in the Atlanta area where seniors can get emergency and/or in-patient care
- 34% of Georgia seniors have a Medicare Advantage plan
- 20% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 46% 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, especially if they are under- or uninsured. The chart below details the common chronic diseases among seniors.
|Disease||Prevalence (in Atlanta)|
|High Blood Pressure||35%|
|Coronary Heart Disease||5%|
Healthcare Costs in Atlanta, GA
On top of so many affected seniors, there are the prices of associated care to consider. Medical drugs, various pieces of equipment, hospital stays, in-home care, and regular visits are all factors which stack up over time, leading to a huge bill. The expense of medical care is on the rise every year, and it doesn’t seem to be slowing any time soon. With seniors living longer lives, this can mean even bigger bills, and more of them. There is no time to wait. You have to know if your coverage is enough in order to protect the things you have spent a lifetime working to get.
|Disease||Prevalence (in Atlanta)||Annual Cost of Treatment|
|High Blood Pressure||35%||$356|
|Coronary Heart Disease||5%||$7,556|
Medicare Advantage Savings in Atlanta, GA
There are some private insurance plans which are approved by the government, and yet not government provided, that are specifically for seniors who are currently enrolled in Medicare. Insurance costs aren’t paid directly by the government, but rather redirected to Medicare Advantage. The government pays their portion of the monthly premium, and the patient pays the rest. In many cases, Medicare Advantage plans are available starting at $0 a month. These plans are required legally to offer at least the same as Original Medicare Part A and B. The majority of insurers offering these sorts of plans also have dental and vision coverages available as well.
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.
A cost effective drug plan is only part of what can be added to Medicare Advantage plans. Doctor appointments, equipment of the medical or pharmaceutical variety, and an economical prescription system, are all options for different Medicare Advantage plans. Even more give the choice to incorporate dental or vision benefits into their packages, as an extra boon. The federal government which would be providing Medicare then instead redirects the funds to the Medicare Advantage plan of your choice. That means you could receive even more coverage for no additional cost! However, copays and coinsurance will still always be the responsibility of the policy holder. And with any insurance policy, there will be some expenses that just aren’t covered.
Medicare Supplement (Medigap) Savings in Atlanta, GA
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.
Right now, there are four plans intended to cover Medicare Part A gaps. Plans A, D, K, and L are all intended for covering the potential gaps in Traditional Medicare. Additional plans do account for Part A, but with Part B as well. Those will be discussed below the chart. However, if you don’t need coverage for Part B, then it would be wise to consider a plan without it, as it will save in premium costs.
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.
There are gaps in Medicare Part B as well to take into consideration. Part A is supposed to take care of hospital visits and inpatient care, and Part B should, in theory, take care of the rest. This isn’t always how things work, however. Copays and coinsurance remain the responsibility of the insured, as usual, and can add up to a considerable amount over time. There are a variety of different plans which can compensate for this so that patients like you don’t get overwhelmed with too many medical bills.
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 Atlanta, 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)|