Health insurance for seniors may be difficult to get above and beyond the standard Medicaid or Medicare coverage. Medicare is the federal health insurance program that covers most people aged 65 and older, while Medicaid is the federal insurance program used to cover those who are disabled no matter what their age. Medicare covers most acute medical conditions or conditions that the patient will recover from but does not cover most care that is given at home, in assisted living facilities or in nursing homes. This gap may be covered by Medicaid, but in most cases, seniors look for other health insurance coverage from private companies.
All of the supplemental plans should work in addition to Medicare or the primary care company. At some point seniors must see specialists for particular health problems and while Medicare does not cover those necessities, many of the supplemental health insurance policies will. Many of the supplemental health insurance policies cover anywhere from 50 percent to 80 percent of the remaining balance after Medicare has paid their part. There are many variables with the different Medicare plans and it’s very hard sometimes to determine if the supplemental insurance policies are worth the extra money. The extra cost must be weighed against the cost of prescription and physician benefits in order to determine whether or not the supplemental plan fits the needs of the senior.
Medicare benefits are provided in four different parts called Parts A, B, C and D.
Medicare Part A is premium-free for most people and will help to pay for inpatient hospital care, some nursing facilities with skilled personnel and hospice.
Medicare Part B, most people pay a monthly premium. This helps to pay for doctors, outpatient hospital care and other therapies such as physical and occupational therapy.
Medicare Part C allows for a variety of Health Maintenance Organizations (HMOs) and Primary Care Physician (PPOs) to cover individuals with Medicare benefits. By federal law, they must provide the same benefits that the original Medicare plan provides, but are allowed to offer additional benefits such as dental and vision care. To control costs these plans are allowed to limit a patient’s choice of practitioners to those who are specifically in the network. In that respect Medicare part C operates much the same as a HMO does.
Medicare Part D provides prescription drug benefits through private insurance companies. This costs and extra premium each month and can vary from state to state and company to company.
Full information of what Medicare covers can be found here.