Medicare Part A and Medicare Part B have an ever-growing mess with expensive coverage gaps. So what happens to those who have conditions that fall into those gaps? They end up paying out of pocket, and the prices can be outrageous. When considering any elderly with chronic conditions, it isn’t just a fight for extra pennies; these insurance gaps can cost people what they have worked for over a lifetime. And as a citizen of Texas, you have a particular set of things to consider when picking the most prudent policy.
Senior Medicare in Fort Worth: Facts and Figures
- There are 83,235 senior citizens living in Fort Worth right now
- There 11 hospitals in the Fort Worth area where seniors can get emergency and/or in-patient care
- 33% of TX seniors have a Medicare Advantage plan
- 19% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 48% of seniors potentially uninsured or underinsured against costly Medicare coverage gaps!
Aging makes everyone more at risk for particular diseases. Most of which will last for the rest of our lives, and require increasing amounts of care. Some may get better, but the more likely option is that they’ll continue to worsen with time. Not only will your health be at stake, but your financial security as well. Medical expenses are on the rise every single year, and fiscal evidence shows they will likely continue well into the future. There is also the potential that you might experience more than one of these diseases at the same time, doubling your medical bills.
|Disease||Prevalence (in Fort Worth)|
|High Blood Pressure||31%|
|Coronary Heart Disease||6%|
Healthcare Costs in Fort Worth, TX
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 Fort Worth)||Annual Cost of Treatment|
|High Blood Pressure||31%||$288|
|Coronary Heart Disease||6%||$7,642|
Medicare Advantage Savings in Fort Worth, TX
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 can offer many seniors better coverage options for their chronic ailments. Diseases like diabetes, arthritis, and high blood pressure are generally progressive and last until end-of-life, plus require extra effort to manage. Drug tests, prescriptions, equipment, additional doctor visits; all of these things can and do culminate over time, resulting in a higher bill. Medicare Advantage can be more effective than just Medicare plans alone. Over time, as these conditions continue to get worse, bills will continue to pile up. Even with Medicare Part D, you can get more coverage and save more money with some Medicare Advantage plans. It’s important to start budgeting now for the inevitable cost.
Not only do Medicare Advantage plans cover as much as Medicare Parts A and B; they can potentially cover even more. This can be doctor visits, various equipment, a prescription plan, or a combination of the three, plus more for most Medicare Advantage policies. Also, most plans come with the option to add dental or vision coverage to the policy you select. The government in turn subsidizes your monthly premium, allowing you to get a deep discount on Medicare Advantage plans. There is even the potential for a payment of $0 a month. Copays and coinsurance will still be patient expenses, and out-of-pocket costs will apply for the few items that your insurance does not cover.
Medicare Supplement (Medigap) Savings in Fort Worth, TX
Medigap is another type of Medicare Supplement Insurance. They work similarly to Medicare Advantage and can save money in covering gaps in traditional Medicare Part A. The most common conditions (heart disease, for example) can cost upwards of five figures just for the hospital stay and administered in-patient treatments alone. At a certain cutoff, Original Medicare plans stop paying, and any remaining balance must come from the patient’s own pocket. A Medicare Supplement Insurance plan can stop that.
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.
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.
Traditional Medicare Part B covers any medical aspect that Part A cannot. This generally includes outpatient procedures, regular office visits, and medical testing home equipment. Responsibilities like coinsurance and copays will remain with the patient, as well as any premium. These costs too can be hard to handle, but thankfully there is no shortage of choices to help further reduce them.
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 Fort Worth 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)||$21||$74||$183|