Health Insurance For Seniors: What are Your Options?
Compared to other countries in the world, the U.S. government spends a much bigger budget on its health sector, as it gives a weighty portion of its gross domestic product (GDP) per year to the country’s healthcare systems.
The country also understands that its people — being in different age groups — have distinct healthcare needs. And to support everyone, the government and private companies have come up with several systems that will cater to the needs of all Americans.
One of these structures is perfectly designed for seniors.
Understanding the Insurance For Seniors in the U.S.
Many seniors do not have enough resources to pay for expensive healthcare costs. Considering their age, their source of income is likely much lower than it was when they were younger and working.
In fact, according to a recent study by the Employee Benefit Research Institute (ERBI), an American couple retiring in 2017 at 65 needed $280,000 in savings to afford their future medical expenses.
While the $280,000 includes premiums for Part B doctor coverage and Part D drug coverage, this amount of money does not include long-term care or assisted living.
Many seniors are eligible for healthcare through programs such as Medicare, Medicaid and the Veterans Administration. Now, let’s dig deeper into the health care options available for seniors.
Health Insurance For Seniors Who Have Worked Full Time For At Least 10 Years
Medicare is the federal health insurance program for seniors older than 65 who have worked full-time jobs for at least 10 years. It is paid for by a combination of a required 2.9% payroll tax levied to all workers and employers. Meanwhile, monthly premiums are paid by enrollees and by the government.
It has four parts:
- Covers hospitalization, care in a skilled nursing facility, hospice care, and some home health care;
- Covers outpatient services, costing $100 per month;
- Medicare Advantage – varies in cost and allows individuals to enroll in Medicare health plans offered by private insurance companies;
- Covers prescription drug costs
Insurance For Low-Income Seniors
Run by individual states and partially funded by the federal government, Medicaid is a health insurance program that caters to low-income individuals, including seniors.
To qualify for Medicaid benefits, an applicant’s assets must be below a certain threshold that varies by state.
Then, Medicaid will pay for most of the costs associated with several types of long-term health care, such as nursing home care, skilled care services at home, and hospice care.
However, Medicaid rules vary from state to state and often are complex.
Health Insurance For Seniors Purchased by Individuals or Provided by Employers
Individual private policies are usually way more expensive than other plans for seniors.
Private health insurance policies are usually purchased by individuals or provided by employers. Employer-sponsored policies typically end when a person retires unless they are part of an employee’s pension or union plan.
Meanwhile, as carriers evaluate an applicant’s health, most seniors with serious medical conditions can be denied coverage.
Health Insurance For Seniors Who Are Veterans, Military Retirees, and Their Spouses
Sponsored by the Veterans Administration (VA), the VA’s health care system covers all veterans, regardless of age, who have served at least two years of continuous active duty, have a service-related disability, or have served in various theaters of war.
Eligible beneficiaries include elderly spouses or widows of certain disabled or deceased veterans.
Health Insurance For Seniors Who Need Assistance with Everyday Activities
Assisted living is a long-term healthcare option crafted for individuals who need assistance with everyday activities, such as meals, medication management, necessities, and more.
While 41 states have waiver programs for low-income seniors, more than 86% of assisted living residents still pay for their rent and services through private, long-term care insurance from their savings.
Health Insurance For Seniors Offered by Hospice and End-Of-Life Agencies and Programs
Hospice care is designed for individuals who are diagnosed with a terminal illness and have used all curative medical care. No one would qualify for this plan unless they have six months or less to live.
Its service may be provided at an individual’s home, a hospital, a hospice facility or a nursing home. Hospice also includes emotional and spiritual support for patients and their families.
As mentioned above, the U.S. government prioritizes health care for its people. True enough, they spend twice as much on health care as the rest of the world’s developed nations.
The country allocates 18% of its GDP to its health care systems, while the budget it allocates for the health care of seniors exceeds 5 percent, which is expected to double by 2030 and triple by 2050.
This also explains why the country has several health insurance options designed for seniors, who have different needs, lifestyles, and positions in life.