Auburn, Maine can be one of the greatest places to live. There are plenty of nice communities, great places to relax, and plenty of affordable healthcare options. But few seniors living in Auburn are aware of how incredibly expensive life can become when you’re trapped in the Medicare coverage gap. These out-of-pocket costs can quickly run up into the tens of thousands of dollars over only a few short years, derailing any of your retirement savings accounts and potentially forcing you back into the workforce. Of course, a few of the aforementioned affordable healthcare options (namely Medicare Advantage and Medigap) can resolve this issue, but you have to make sure to be proactive enough to obtain them. Let’s take a quick look at how the numbers stack up in Auburn.
Facts and Figures
- There are 3,896 senior citizens living in Auburn right now
- There are 10 hospitals in the Auburn area where seniors can get emergency and/or in-patient care
- 27% of Maine seniors have a Medicare Advantage plan
- 28% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 45% of seniors potentially uninsured or underinsured against costly Medicare coverage gaps!
Judging from these numbers, it looks like Auburn is one of the healthier places in the country, at least in terms of access to healthcare. However, the only reason for this is that a majority of seniors in the area have already taken care of securing their healthcare coverage options. In reality, there are still thousands of seniors who lack the necessary access to healthcare. For senior citizens, this can mean the difference between an end to your retirement and other much worse consequences. This becomes particularly troublesome when combined with the fact that there are a wide number of diseases, illnesses, and disorders that become more frequent and/or more severe as you age, catching seniors in a sort of double jeopardy. For a better understanding of the prevalence of a few of these diseases, consult the chart below.
|Disease||Prevalence in Auburn|
|High Blood Pressure||34%|
|Coronary Heart Disease||6%|
Healthcare Costs in Auburn, ME
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 Auburn||Annual Cost of Treatment|
|High Blood Pressure||34%||$356|
|Coronary Heart Disease||6%||$9,860|
Medicare Advantage Savings in Auburn, ME
For many seniors, these increased costs are the exact opposite of what they were expecting when they first entered retirement. After a lifetime of paying into the Medicare program with politicians promising that their money will be used to pay for retirement, many seniors in Auburn were faced with an unfortunate truth: Medicare doesn’t cover everything. Medicare Advantage plans, on the other hand, strive to. In fact, Medicare Advantage plans are required by law to cover everything that is promised under Original Medicare. Moreover, providers of these plans (i.e., private insurance companies, not the government) typically give customers the option to pay a little extra in premiums in order to receive additional benefits. Of course, thanks to the government picking up the slack, the “little extra” that you’ll have to pay can typically amount to $0 in monthly premiums.
One of the primary benefits of Medicare Advantage is that providers of these plans typically offer prescription drug coverage options in addition to a wide variety of other possible add-ons and expansions. For most seniors, this means no longer having to worry about whether or not your retirement savings are going to last long enough for you to be able to afford next month’s prescription medications. Moreover, this drug coverage often extends to cover necessary medical equipment, including things like glucose monitors and testing strips, making Medicare Advantage plans a highly sought-after plan among seniors with chronic health conditions. For these seniors, the benefits over a five- and ten- year period speak for themselves, with Medicare Advantage plans often saving them more than $20,000 over a span of only 120 months.
Two more common coverage options for Medicare Advantage plans are dental and vision coverage. By selecting a Medicare Advantage plan and adding on these two coverage options, seniors can improve their access not only to healthcare coverage but for both dental and vision care as well, enabling you to save even more money over a longer period of time than with a standard Medicare Advantage plan. This is something that Original Medicare and Medicare Supplement (Medigap) insurance plans do not provide; however, with Medigap, there are a few ways to get around this lack of a comprehensive coverage plan without breaking the bank. In fact, depending on the nature of your medical needs, Medicare Advantage might not even be the right option for you.
Medicare Supplement (Medigap) Savings in Auburn, ME
Unlike Medicare Advantage, Medicare Supplement (Medigap) insurance plans don’t involve completely replacing your Original Medicare; rather, they supplement it, as the name suggests. These plans enable you to keep the Medicare benefits that are working for you while supplementing the coverage gaps that are causing you the most problems. Overall, there are ten different Medigap plans from which to choose, each providing different benefits. Mostly, they focus on covering Medicare Part A coverage gap expenditures and they do so quite well. There are, of course, a wide variety of differences between each plan type, so it is vital that you speak with a medigap professional before making a decision that can affect you for the rest of your life.
The first category includes Medicare Supplement Plans A, D, K, and L. These plans are designed specifically to ensure that you can obtain the access to healthcare necessary to afford hospital and in-patient care whenever you need it. This quality makes these plans wonderful options for seniors who find that their Original Medicare coverage doesn’t go far enough in covering their Medicare Part A expenses (a common occurrence for seniors who suffer from chronic and severe health conditions) although it does cover all or almost all of their Medicare Part B expenses. However, it is important to note that Plans A, D, K, and L only offer coverage for Medicare Part A and its related expenses, providing nothing for Medicare Part B.
If, however, your Medicare Part B costs are presenting you with just as much difficulty as your Medicare Part A costs, you’re not going to get as much benefit out of the above-mentioned type A, D, K, or L plans. Instead, you’re going to need to look into type B, C, F, G, M, and N plans.
The reason for this, to put it simply, is that only the latter plans cover both Part A and Part B gaps in coverage. What does this mean for you? If you’re like most seniors and are spending money on more than just hospital visits, odds are you will have coverage gaps in the hundreds or even thousands of dollars without one of these plans that cover both Part A and Part B.
In the past, type F plans were available and could also help you protect yourself against age-related illnesses and their costs. Unfortunately, beginning in 2021, this type of plan will no longer be offered. This means you have less than a year to get grandfathered into a Plan F policy, or lose those benefits forever.
One of the major downsides to Medicare Supplement plans in comparison to Medicare Advantage plans is that Medicare Supplement plans do not include coverage for prescription medications, vision, or dental. If you find that you need help improving your access to any of these categories, then you will most likely benefit more from Medicare Advantage than from Medigap coverage plans.
Of course, if you prefer the options afforded to you by Medigap plans and would rather stick with one of those, that’s a perfectly viable option. In fact, there are many other seniors in Auburn with this same idea. In that case, you can simply pay extra for private insurance coverage of these categories. In general, these are by far the most affordable private plans.
It is more important today than ever before for seniors living in Auburn, Maine to protect their health. For almost half of the senior population in this city alone suffering from being uninsured or underinsured, the risk of age-related injury or illness increases every day, but it doesn’t have to. You can take your health into your own hands today. Go online to Medigap.com and start shopping for healthcare plans that work for you. Your future self will thank you.
|Medigap Plan||Minimum Monthly Premium||Maximum Monthly Premium||Average Estimated Monthly Premium (Part B Premium Included)|
|Plan F (high deductible)||$45||$92||$204|