In current times, retirees are finding themselves buried in debt due to exposed gaps in their Medicare Parts A and B. It’s unfortunately not much of a shock anymore. Everywhere you go, it is crazily difficult for seniors to have a truly comprehensive plan offered for a cost that is affordable on what’s often a fixed income. Happily, this is where gap insurance comes in and can help save the day (and some lives if all goes well).
Senior Medicare in Lexington: Facts and Figures
- There are 39,501 senior citizens living in Lexington right now
- There 10 hospitals in the Lexington area where seniors can get emergency and/or in-patient care
- 28% of Kentucky seniors have a Medicare Advantage plan
- 22% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 50% 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 Lexington seniors.
|Disease||Prevalence (in Lexington)|
|High Blood Pressure||33%|
|Coronary Heart Disease||6%|
Healthcare Costs in Lexington, KY
We cannot look at prevalence alone without considering the cost factor of these diseases. Prescriptions, medical equipment, hospital time, at-home care, and scheduled check-ups all have a cost which culminate eventually. Medical costs continue to rise every single year, and seniors are living longer lives now more than ever. When considering these facts, the potential cost can get chillingly pricey, and fast. It is vital that you have the right health coverage going into the final stage of life if you want to protect your investments, yourself, and your future.
|Disease||Prevalence (in Lexington)||Annual Cost of Treatment|
|High Blood Pressure||33%||$356|
|Coronary Heart Disease||6%||$8,714|
Medicare Advantage Savings in Lexington, KY
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.
Medicare Advantage plans can offer many seniors better coverage options for their chronic ailments. Diseases like diabetes, arthritis, and high blood pressure are generally progressive and last until end-of-life, plus require extra effort to manage. Drug tests, prescriptions, equipment, additional doctor visits; all of these things can and do culminate over time, resulting in a higher bill. Medicare Advantage can be more effective than just Medicare plans alone. Over time, as these conditions continue to get worse, bills will continue to pile up. Even with Medicare Part D, you can get more coverage and save more money with some Medicare Advantage plans. It’s important to start budgeting now for the inevitable cost.
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 Lexington, KY
Medigap is another type of Medicare Supplement Insurance. They are different from Medicare Advantage, but can at least save you money in covering gaps in traditional Medicare Part A. The most common conditions (heart disease, for example) can cost upwards of five figures just for the hospital stay and administered in-patient treatments alone. At a certain cutoff, Original Medicare plans stop paying, and any remaining balance must come from the patient’s own pocket. A Medicare Supplement Insurance plan can stop that.
Currently, there are four different plans tailored for exactly the above coverages. These plans are: Plans A, D, K, and L. There are additional plans which cover gaps in Part A as well as gaps in Part B, but we will discuss those in a moment. For now, it is important to understand that if you do not need the gap coverage for traditional Medicare Part B, buying a supplement plan which only covers gaps in Part A will come with a lower premium, thus saving even more money.
Other Medigap plans available are Plans B, C, D, F, G, M, and N. They cover Medicare Part A costs as well as differing portions of Part B. The more coverage your plan provides, the more the monthly premium will cost. But this also means far fewer out-of-pocket surprises when situations arise, both for Medicare Part A and Medicare Part B. A few dollars more in premiums could save potentially thousands in medical bills. It is worth noting that Plan F will be retiring at the end of 2020, and you cannot enroll in it after December of 2020.
Medicare Part B has its own gaps as well. Part A handles hospitals and inpatient procedures; Part B is supposed to cover most of everything outside of that. This includes outpatient operations, check-ups from doctors, even some small pieces of medical equipment. However, the co-pays, coinsurance, and yearly premiums for Medicare Part B can be incredibly costly over time, so much so that it can become unmanageable quite quickly. Fortunately, there are many Medigap plans which account for this and are designed to help reduce Medicare Part B expenses so patients don’t get bogged down financially.
Medicare Advantage offers plans which cover incidental costs with prescriptions, dental, or vision coverages. Medicare supplement (or Medigap) plans do not. Medicare itself does give the option for Part D coverage which is very inclusive for many types of prescription medications. A quick online search can uncover excellent local sources of dental or vision insurers which offer discounts to seniors.
For Lexington seniors, having budget-friendly Medicare is integral to securing a comfortable, livable retirement, not to mention protecting any accrued savings. It is sad to say, but medical costs seem to only continue rising over time, and it is due to factors far beyond our control. But what we do have control over are the ways in which we prepare. You need to find a Medicare supplement insurance plan that will help you when you need it most, and keep you safe from pricy gaps. We want to help make that happen.
|Medigap Plan||Minimum Monthly Premium||Maximum Monthly Premium||Average Estimated Monthly Premium (Part B Premium Included)|
|Plan F (high deductible)||$27||$60||$179|