Medicare Parts A and B have wide gaps in their coverage that can leave Knoxville seniors in danger of receiving surprise medical bills. What happens to these seniors who fall into those gaps? They then must pay the leftover bills out of pocket. It doesn’t take a financial genius to understand that the costs for huge medicinal expenses are likely beyond what an average retiree can afford. When thinking about seniors with chronic illnesses, it’s not only a fight for spare change. These gaps can cost people what they have spent a lifetime to save. As a resident of Tennessee, you have different challenges when choosing the best policy.
Senior Medicare in Knoxville: Facts and Figures
- There are 24,750 senior citizens living in Knoxville right now
- There 9 hospitals in the Knoxville area where seniors can get emergency and/or in-patient care
- 36% of TN seniors have a Medicare Advantage plan
- 16% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 48% of seniors potentially uninsured or underinsured against costly Medicare coverage gaps!
Time wears at us all, and eventually even those of us in the best shape will begin to lose more and more of our vitality. It is part of aging, and though humanity has long tried, it cannot be avoided. These diseases come and often have no ‘cure’, so patients never are able to fully heal. This leaves the only choice to be continual care and symptom management, which is costly at best. And to make matters worse, many of these diseases are symptomatic and causally related to one another, making it very likely for seniors to have multiple of them at the same time. This can double or even triple medical expenses in an instant. Below is a chart of the most prevalent chronic diseases in Knoxville:
|Disease||Prevalence (in Knoxville)|
|High Blood Pressure||36%|
|Coronary Heart Disease||7%|
Healthcare Costs in Knoxville, TN
When considering healthcare, cost has to be one of the factors at the forefront of your mind. Medications, testing equipment, hospital care, general outpatient procedures, check-ups; all of these combine to create a hefty bill. Seniors are living much longer now, but when those years have a price tag attached, it severely lessens the quality of life. No one wants to feel like they’re just alive to pay more and more bills. And with costs ever rising, it’s easy to see how all of this can become so quickly overwhelming for anyone, let alone ill seniors, even if they have saved ahead of time. It is critical that you are informed about your health options so that you can protect yourself into and throughout your golden years.
|Disease||Prevalence (in Knoxville)||Annual Cost of Treatment|
|High Blood Pressure||36%||$354|
|Coronary Heart Disease||7%||$8,867|
Medicare Advantage Savings in Knoxville, TN
Medicare Advantage is a form of private insurance not directly offered by the federal government. It is approved, however, by the government to offer to those who are approved to receive Medicare. Instead of paying your insurance directly, the government forwards their portion to Medicare Advantage, and you pay the remainder as the premium. The 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 have said they feel their coverage is better with Medicare Advantage plans than under Medicare. It is unfortunate but common for chronic diseases to necessitate on-going professional medical care, whether for prolonged treatment or to reduce the appearance of symptoms and improve overall quality of life. With time, conditions worsen and costs rise, leaving patients in worse condition than before. Medicare Advantage can be more comprehensive than coverage offered by Medicare alone, even with Part D.
What can be included within Medicare Advantage plans only begins at a cost effective drug plan. Doctor’s appointments, equipment of the medical variety, an economical prescription system; each of these are options for Medicare Advantage plans. More give the options to incorporate dental or vision into the packages, as an additional benefit. The government which would be providing Medicare then redirects the funds to Medicare Advantage. That means you can get more coverage for potentially no additional cost. However, copays and coinsurance are always the responsibility of the insured. As with any insurance, there will be certain expenses that are excluded.
Medicare Supplement (Medigap) Savings in Knoxville, TN
Medigap is a similar type of Medicare Supplement. It works very similarly to Medicare Advantage in some ways. Medigap can save money by covering gaps in Medicare Part A. The common conditions (heart and kidney disease, for example) cost five figures or more for just the hospital stay and any in-patient treatments. After a few days, Medicare stop paying and any remaining cost then has to come from the patient’s pocket. A Medigap plan can stop that.
Plans A, D, K, and L are designed to cover the hidden costs for the gaps in coverage for Medicare Part A. Other Medigap plans have Part A coverage along with Part B, but we’ll discuss those in a minute. If Part B costs aren’t something you will need, you then shouldn’t purchase them. This will save you more premium for other costs. If hospital stays from Part A are your concern, Plans A, D, K, and L are the ones you should consider first.
Now, if you do want coverage for gaps in Medicare Parts A and B, then Medigap plans B, C, F, G, M, and N are the ones to see. Naturally, the more in-depth coverage you choose for your plan, the more your monthly premium will likely total. However, this means far fewer out-of-pocket costs and unexpected financial strikes. Plan F is retiring soon, and is not going to be available after the year 2020.
Medicare Part B has just as many gaps as Part A. Part A pays for the cost of hospital visits and procedures. Part B is supposed to cover everything else. This includes operations, check-ups, appointments with specialists, even some small pieces of equipment. However, the combination of the co-pays, coinsurance, and yearly premiums for Medicare Part B can add up to a pile of debt in the blink of an eye. Fortunately, there are Medigap plans which cover for this and are created to help reduce these expenses so patients don’t get entirely overwhelmed financially.
Medigap does not cover prescriptions, dental, or vision, unlike Medical Advantage. But Medicare does have Part D, which is specifically for purchasing medical prescriptions. Part D is available for anyone who is eligible for Medicare, whether they have any other Medicare plan or not. Also online are hundreds of additional plans specifically for dental or vision in the Knoxville area. These can be found with an easy Google search.
Every senior living in Knoxville, Tennessee has to know that having supplemental Medicare coverage is important for going into the next stage of life. It protects your health, and your retirement. Medical costs continue to rise for all every year, but especially seniors. That is beyond any of our control. But what we can control is how well we get ready for what’s coming. You have to find a Medicare supplement policy that covers your medical needs and still fits your limited budget. We can help you find that policy right now.
|Medigap Plan||Minimum Monthly Premium||Maximum Monthly Premium||Average Estimated Monthly Premium (Part B Premium Included)|
|Plan F (high deductible)||$29||$92||$196|