Medicare Part A and Medicare Part B have had extensive problems with expensive coverage lapses. So what befalls those who have illnesses that fall into those gaps? Patients end up paying out of pocket, and the bills can be crazy. When considering any elderly loved one with chronic ailments, it isn’t just a desire for extra money either; these insurance holes can cost people what they have worked for over an entire lifetime. And as a citizen of Oklahoma, you have a particular set of challenges to consider when picking the most prudent policy.
Senior Medicare in Tulsa: Facts and Figures
- There are 53,689 senior citizens living in Tulsa right now
- There 10 hospitals in the Tulsa area where seniors can get emergency and/or in-patient care
- 18% of Oklahoma seniors have a Medicare Advantage plan
- 24% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 58% 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 Tulsa.
|Disease||Prevalence (in Tulsa)|
|High Blood Pressure||36%|
|Coronary Heart Disease||7%|
Healthcare Costs in Tulsa, OK
On top of so many affected seniors, there are the prices of associated care to consider. Medical drugs, various pieces of equipment, hospital stays, in-home care, and regular visits are all factors which stack up over time, leading to a huge bill. The expense of medical care is on the rise every year, and it doesn’t seem to be slowing any time soon. With seniors living longer lives, this can mean even bigger bills, and more of them. There is no time to wait. You have to know if your coverage is enough in order to protect the things you have spent a lifetime working to get.
|Disease||Prevalence (in Tulsa)||Annual Cost of Treatment|
|High Blood Pressure||36%||$356|
|Coronary Heart Disease||7%||$8,967|
Medicare Advantage Savings in Tulsa, OK
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 with chronic ailments have stated that they feel the coverage is better for their needs with Medicare Advantage plans. Most chronic diseases – for instance, arthritis, high blood pressure, and diabetes – mandate constant management and effort to control. This can include medications, equipment for testing, and an increased number of doctor and hospital visits, among others. Sadly, these conditions tend to get progressively worse, which ends up costing more and more as time goes by. There are Medicare Advantage plans which can cover even more than a Medicare plan which includes extras, like Part D. It is time to start saving with Medicare Advantage, in order to be prepared when the time arrives.
Medicare Advantage plans cover every bit as much as Medicare Parts A and B, and then even more. They can include all of those doctor visits and pieces of equipment, as well as potentially a plan for necessary drugs. A majority of the offered plans are presented with an option to include any combination of the variety of expenses – even dental or vision. Since the government pays a portion of the Medicare Advantage premium, many seniors can enjoy an additional monthly premium starting as low as $0. Coinsurance and copays will still be patient responsibilities, as well as out-of-pocket costs, but they will be significantly reduced.
Medicare Supplement (Medigap) Savings in Tulsa, OK
There is another type of policy called Medigap, which is a Medicare supplement. They work a bit differently to a Medicare Advantage policy, but they can still save a great amount of money, particularly when covering gaps in Medicare Part A. The biggest chronic conditions, like coronary heart disease or kidney disease, can cost thousands just for the stay in the hospital and treatments while there. These stays can be incredibly long, and after a certain point, traditional Medicare stops coverage. You will have to have some sort of backup coverage, or face paying astronomical costs to continue care.
Medigap Plans A, D, K, and L are the ones designed to cover the pricey costs for the lack of coverage in Medicare Part A. The other Medigap plans have Part A coverage as well, but include extras that we’ll touch on in a minute. If Medicare Part B costs aren’t something you need, you then shouldn’t feel the need to purchase them, thus saving you more premium. If hospital stays from Part A is your concern, Plans A, D, K, and L are the ones you may wish to consider first.
Medigap plans B, C, D, F, G, M, and N, cover gaps in Medicare Part A as well as select aspects of gaps in Medicare Part B. The more in-depth coverage your plan offers, the higher your monthly premium will be. However, this also means fewer out-of-pocket expenses and unexpected financial hits. Take note, Plan F is retiring soon, and will not be available for enrollment after the year 2020.
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 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 Tulsa seniors, it is imperative that they have the proper amount of health coverage, and at an affordable price for all. It protects you, your savings, and your family from any additional and unnecessary hardship or financial burden. Our health and rising costs to cover it are factors beyond any one person’s control. However, we can control how we prepare for the future. A Medicare coverage gap policy is the best way to do that, and we want to help you find the best policy for tomorrow’s needs, today.
|Medigap Plan||Minimum Monthly Premium||Maximum Monthly Premium||Average Estimated Monthly Premium (Part B Premium Included)|
|Plan F (high deductible)||$23||$80||$187|