Medicare Options as You Age

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Did you know that Medicare covers only about half of the expected healthcare costs for people over age 65? We found helpful information that explains Medicare coverage limits and describes options that may help you pay for your healthcare as you age.
During the next decade over 10,000 people will enroll in Medicare daily and face a new set of complex health care decisions. If you or a loved one will be one of them, it’s important to understand your options for financing your healthcare costs beyond Medicare coverage. A recent study found that many people age 55 to 64 are unaware of options to Medicare.

Identifying the best financial resources to pay for increasing elder age care can seem overwhelming. A recent Mount Sinai School of Medicine study found that out-of-pocket healthcare expenses exceeded total assets for 43 percent of Medicare patients during the last five years of life.

What does Medicare cover? Medicare Parts A and B pay for medically necessary procedures, equipment and care. Part A covers hospital care and some nursing care and hospice costs. Part B covers physician appointments, lab testing and medical equipment.

Healthcare copayments, coinsurance and other costs not covered by Medicare can add up quickly. For example, Medicare coverage for nursing care is limited to skilled care performed by a medical professional based on medical necessity. Custodial care such as bathing and feeding is covered for a limited time during skilled care only.

Other healthcare expenses commonly needed after age 65 that aren’t covered by Medicare A and B include dentures, hearing exams and aids, eye exams, corrective lenses, long-term care and custodial care. These expenses can easily cost elderly patients that are least able to pay many thousands of dollars each year.

What are your healthcare coverage options beyond Medicare after age 65? They include:

  • Medicare Advantage, known as Medicare Part C, is sold by private insurers and may offer vision, dental and hearing coverage that basic Medicare coverage doesn’t. Part C rarely covers long-term care, so ask insurers about nursing care coverage before purchasing.
  • A Medicare supplemental policy, known as a Medigap policy, covers Medicare Part A and B deductibles and co-pays if the service is partially covered by Medicare.
  • Medicaid may be an option if you have limited financial resources or have depleted most of your assets to pay for your healthcare. Requirements and coverage varies by state so check your state’s coverage details.
  • Long-term care insurance is private insurance that you or an employer may purchase. Be sure you understand coverage specifics for long-term or nursing care before you purchase.

You can also file appeals if you’re denied coverage or negotiate with providers if you need services you can’t afford.

Read more about options to Medicare here.

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