Medicare Part A and Medicare Part B have expanding chaos with costly insurance gaps. So what happens to those patients who have illnesses that happen to be in those cracks? They end up paying their bills out of pocket, and the costs can be insane. When thinking about any elder with chronic conditions, it isn’t just a battle for extra bucks either; these insurance gaps can cost entire life savings. And as a citizen of North Carolina, you have a particular set of situations to consider when picking the most effective policy.
Senior Medicare in Raleigh: Facts and Figures
- There are 45,521 senior citizens living in Raleigh right now
- There 10 hospitals in the Raleigh area where seniors can get emergency and/or in-patient care
- 32% of North Carolina seniors have a Medicare Advantage plan
- 25% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 43% of seniors potentially uninsured or underinsured against costly Medicare coverage gaps!
Many seniors are afflicted with particular types of disease as they reach a certain age. Unfortunately, these tend to be the variety which are lingering and persistent, requiring care from diagnosis to end of life. Many can worsen over the passage of time, making medical costs skyrocket as the years pass. There is substantial evidence to suggest that seniors will likely suffer more than just one of these ailments at a time, too. That means costs doubling and tripling in a blink. Here are the more prevalent chronic diseases in Raleigh.
|Disease||Prevalence (in Raleigh)|
|High Blood Pressure||27%|
|Coronary Heart Disease||4%|
Healthcare Costs in Raleigh, NC
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 Raleigh)||Annual Cost of Treatment|
|High Blood Pressure||27%||$356|
|Coronary Heart Disease||4%||$7,493|
Medicare Advantage Savings in Raleigh, NC
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.
Medicare Advantage plans offer better coverage for the needs of seniors with these common chronic illnesses, according to the statements 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.
Medicare Advantage can cover even more than Original Medicare Parts A and B. Doctor visits, testing equipment, and drug plans are options as well. Many plans allow the option to add vision or dental coverage for additional premium costs. Thanks to the government paying some or potentially all of the premium, seniors can get a fully comprehensive Medicare Advantage plan starting as low as $0 a month out-of-pocket for premium cost. There will still be certain items that insurance doesn’t cover, like copays or coinsurance, which will be the responsibility of the plan holder.
Medicare Supplement (Medigap) Savings in Raleigh, NC
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 addition 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 designed to cover the gaps in Part A of Medicare. These plans are A, D, K, and L. They are designed to save you money, while keeping you protected. Other plans offered cover gaps in Part A as well as Part B, but more on that below. If you don’t expect Medicare Part B to have extraneous costs and are more concerned about hospital says and associated expenses, you should know that Medigap policies which cover only Part A gaps are less expensive than others. The lower monthly cost could save even more money over time.
The plans we previously referred to but didn’t discuss are Medigap Plans B, C, D, F, G, M, and N. These plans not only cover Medicare Part A gaps, but also Medicare Part B gaps. Of course, more comprehensive coverage leads to larger premiums every month, but lesser out-of-pocket costs when the time actually comes to use your policy. Also note that Plan F is being retired after the year 2020, and you will no longer be able to enroll in it after that year.
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 Raleigh, 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)|
|Plan F (high deductible)||$26||$80||$189|