Medicare Parts A and B have often hidden and usually pricey coverage gaps. What happens to patients who have conditions that fall under those gaps? Seniors end up paying out of pocket, and the prices can be astronomical. When considering anyone with chronic conditions, it isn’t just a fight for some spare cash; these insurance gaps can cost people what they have worked for over a lifetime. And as a citizen of Ohio, you have a particular set of things to consider when choosing the most effective policy.
Senior Medicare in Toledo: Facts and Figures
- There are 37,671 senior citizens living in Toledo right now
- There 10 hospitals in the Toledo area where seniors can get emergency and/or in-patient care
- 35% of OH seniors have a Medicare Advantage plan
- 19% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 46% 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 Toledo.
|Disease||Prevalence (in Toledo)|
|High Blood Pressure||37%|
|Coronary Heart Disease||8%|
Healthcare Costs in Toledo, OH
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 Toledo)||Annual Cost of Treatment|
|High Blood Pressure||37%||$356|
|Coronary Heart Disease||8%||$9,064|
Medicare Advantage Savings in Toledo, OH
The federal government has approved Medicare Advantage as a form of private health insurance. It is open to senior citizens who are eligible to be on Medicare, even if they are not currently enrolled in a Medicare plan. Instead of the government paying for your medical bills directly, they send their contribution towards your Medicare Advantage premium, and you only owe the difference. In many cases, this ends up being zero. These plans, by law, have to cover at least Medicare Parts A and B, and more cover additional in the form of vision or dental.
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 cost continues 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 Toledo, OH
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 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.
The plans we previously referred to but didn’t discuss are Medigap Plans B, C, 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.
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 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 Toledo area, which can be found through a simple Google search.
For seniors living in Toledo, just like you, purchasing the most affordable Medicare Supplement Insurance is absolutely necessary. Not only does it protect any retirement savings, it also grants peace of mind. Sad as it is, medical costs are continually on the rise, and they do not show signs of decreasing any time soon. It’s beyond your control, but one thing that is in your hands is how well you cover yourself with a comprehensive insurance plan. We want to help you find that supplemental Medicare gap coverage plan today.
|Medigap Plan||Minimum Monthly Premium||Maximum Monthly Premium||Average Estimated Monthly Premium (Part B Premium Included)|
|Plan F (high deductible)||$28||$69||$184|