Costly gaps in insurance coverage for Medicare Parts A and B is nothing new. But what can we do about it? For the more venerably aged among us, these sorts of battles aren’t just for pocket change. They can mean the difference between life and death. As a resident of Maryland, 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 Baltimore: Facts and Figures
- There are 77,120 senior citizens living in Baltimore right now
- There 10 hospitals in the Baltimore area where seniors can get emergency and/or in-patient care
- 11% of Maryland seniors have a Medicare Advantage plan
- 15% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 74% of seniors potentially uninsured or underinsured against costly Medicare coverage gaps!
Becoming more vulnerable to disease is part of aging. It happens to everyone. And worse, most of the diseases we become more vulnerable to are chronic and will require treatment for the rest of our lives. This only makes medical costs even worse. Also, it is entirely possible that we will have more than one major disease at the same time, compounding difficulties and expenses. The chart below outlines the prevalence of the most common chronic diseases plaguing seniors in Baltimore:
|Disease||Prevalence (in Baltimore)|
|High Blood Pressure||39%|
|Coronary Heart Disease||7%|
Healthcare Costs in Baltimore, MD
Of course, it is vital to understand how expensive these diseases are to treat. Prescriptions, medical equipment, in- and out-patient care, doctor appointments; it all adds up. Not to mention, all medical costs in general are on the rise every year. A doctor’s appointment today is more expensive than the same doctor’s appointment at the same office with the same doctor this time last year. The upside is, thanks to advancing medicine, seniors are living longer. But they’re also incurring more and more medical debt. This means it is more important now than ever before to ensure your coverage is up to snuff going into your senior years.
|Disease||Prevalence (in Baltimore)||Annual Cost of Treatment|
|High Blood Pressure||39%||$359|
|Coronary Heart Disease||7%||$7,854|
Medicare Advantage Savings in Baltimore, MD
While Medicare Advantage is not government-issued, it is government-approved. Technically, Medicare Advantage is a separate, private insurance plan, but with very unique benefits. Insurance costs aren’t paid for by the government, but instead they redirect your intended costs to Medicare Advantage, and any remainder becomes the patient premium. This cost can be, in many cases, as low as $0 a month. Medicare Advantage must cover at least the same as Medicare Parts A & B, but many outside insurers offer add-on benefits for more premium.
Medicare Advantage plans offer better coverage for the needs of seniors with these common chronic illnesses, according to the MDments of those seniors themselves. Every illness, but especially those that are long-term and near the end of life, requires consistent management to alleviate symptoms and ensure a good quality of life. This can include prescriptions, testing items, frequent doctor visits, and more. As these conditions worsen, costs still continue to increase. Fortunately, there are Medicare Advantage plans which can cover even more than a traditional Medicare plan, even when said Medicare plan includes extras like Part D. To be ready for your remaining future, you have to prepare beforehand with Medicare Advantage.
With Medicare Advantage plans, you can receive much more inclusive benefits than traditional Medicare Parts A & B. They include visits to the doctor, necessary equipment, and potentially a valuable money-saving drug plan. A good portion of plans also include the option to add dental coverage or vision coverage to the policy. Because the government pays their portion of the monthly premium, the cost to seniors is drastically reduced, and in some cases can even be as low as $0 per month! Copays and coinsurance will still need to come from out-of-pocket, and there may be other items that are not covered by your insurance policy, no matter how broad it is.
Medicare Supplement (Medigap) Savings in Baltimore, MD
Medigap policies (additional Medicare supplement policies, which go by the nickname Medigap) have distinct differences from Medicare Advantage, but they can still save you plenty of money. This applies especially to the costly gaps in Medicare Part A. Hospital visits from coronary heart disease or kidney disease can end up totaling in the high five, low six digit range. And that’s just for a visit, not including all of the inpatient treatments you might need, or additional medications or services while you’re there. Long hospital stays aren’t covered by Medicare. Neither are sometimes life-saving blood transfusions. It is only sane to have some sort of coverage to protect you from having to pay these sorts of costs out of pocket.
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.
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.
But what gaps are there in Medicare Part B? We know Part A is hospital stays and inpatient care, so what is left for Part B? Nearly everything else. Any outpatient procedures, specialist check-ups, medical or therapeutic gear, supplies or necessities. These are all supposed to be covered under Medicare Part B, but of course, there are always exceptions like copays and coinsurance. Still, there are Medigap plans designed to pitch in with those sorts of costs.
Medicare Supplement Insurance does not cover any prescriptions, dental, or vision care, unlike Medical Advantage. But Traditional Medicare does have Part D available, which is specifically for purchasing medical drugs. Part D is available for purchase for anyone eligible for Medicare, whether or not they have any other Medicare plan currently as their main coverage. Also available online are hundreds of alternative medical plans for dental or vision in the Baltimore area, which can be found through a simple Google search.
Seniors living in Baltimore, MD must know that having supplemental Medicare coverage is necessary for going into the final stage of life. It protects your retirement, and your health. Medical costs are only going to continue to rise for all, and especially seniors. That is beyond anyone’s control. But what you can control is how well you prepare. You must find a Medicare supplement policy that is comprehensive enough for your medical needs, and still fits your monthly budget. We want to help you find that policy today.
|Medigap Plan||Minimum Monthly Premium||Maximum Monthly Premium||Average Estimated Monthly Premium (Part B Premium Included)|
|Plan F (high deductible)||$31||$94||$198|