Medicare Part A and Medicare Part B are riddled with potentially expensive insurance gaps. What happens to someone who develops a condition that falls under one of those gaps? They end up paying out of pocket, and the prices can be completely unreachable. When considering any elderly person with a chronic condition, it isn’t just a fight for extra pennies either; these insurance gaps can cost people what they have worked for over a lifetime of saving. And as a citizen of New York State, you have a particular set of things to consider when picking the most suitable policy.
Senior Medicare in Buffalo: Facts and Figures
- There are 31,269 senior citizens living in Buffalo right now
- There 10 hospitals in the Buffalo area where seniors can get emergency and/or in-patient care
- 38% of New York seniors have a Medicare Advantage plan
- 12% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 50% of seniors potentially uninsured or underinsured against costly Medicare coverage gaps!
When the human body reaches maturity and past, changes continue in our physiological makeup. Some things just begin to break down after so many years, no matter how good of a condition their owner tries to keep them in. Those types of sicknesses are the sort which never quite get better because there is no ‘cure’, only continuing treatment and management. People with those illnesses can still live perfectly full, happy lives, but the cost of managing a prolonged disease is not an inexpensive one, especially if there is more than one illness at once. Below are the most frequent chronic diseases in Buffalo.
|Disease||Prevalence (in Buffalo)|
|High Blood Pressure||37%|
|Coronary Heart Disease||7%|
Healthcare Costs in Buffalo, NY
We cannot talk about chronic disease without talking about money. Medicine, equipment, hospital care, doctor’s visits; they all add up quickly. And they keep adding up as more time goes on. Seniors are living longer lives than ever, which is fantastic. But that quality of life quickly diminishes when crushed under the weight of unending medical debt. Now is more important than ever to ensure you have adequate protection for the next phase of your life. Affordable, comprehensive, helpful healthcare coverage is the most important preparation.
|Disease||Prevalence (in Buffalo)||Annual Cost of Treatment|
|High Blood Pressure||37%||$354|
|Coronary Heart Disease||7%||$7,671|
Medicare Advantage Savings in Buffalo, NY
While the name ‘Medicare’ might make you think these programs are government-offered, that is not actually the case. Medicare Advantage is its own form of private insurance. It is approved by the government to sell to seniors who are already enrolled in Medicare. Instead of paying for your insurance costs directly, the government pays their share to Medicare Advantage, and you pay the rest of the premium. Law requires that Medicare Advantage plans provide at least every benefit which a Traditional Medicare plan offers, but they go much further than just basics.
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 costs continue 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.
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 Buffalo, NY
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, 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.
But what gaps are there in Medicare Part B? We know Part A is hospital stays and inpatient care, so what is left for 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 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 Buffalo 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)||$26||$80||$189|