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Healthcare for Seniors: Navigating Complex Systems and Services

Florida Health Insurance Agency

Healthcare for seniors may be daunting, especially  since the industry has changed in recent years. For example, original Medicare has recently expanded from two parts to four and has several supplemental plans. 

Due to the ever increasing volume of information it may be challenging to navigate care options, particularly for those who experience difficulty with modern technology. Based on a recent report, seniors stated that they found it frustrating and difficult to compare insurance plans due to the information volume and inability to organize them. 

But you no longer need to worry! Private insurance companies like My Healthcare Direct are well-equipped to advise you on all aspects of healthcare. To alleviate your stress, consult our guide for navigating healthcare for seniors. 

image of female healthcare worker speaking with senior citizen healthcare for seniors

Tips For Navigating Health Insurance As A Senior

Consult An Insurance Agent

Due to the obstacles the elderly face in learning about health insurance, it’s best to consult the experts. Instead of struggling to sort through information online, an experienced professional will inform you about the following:

  • Eligibility
  • Application requirements
  • Finding in-network specialists
  • Selecting the best policy based on your health
  • Inform you about copays and deductibles

Speaking with an agent will also help you select the most affordable policy based on your income.

Evaluate Coverage Options

After consulting an expert, you should carefully review your options. Specifically, as a senior, you should pick an insurance that covers your non-negotiable needs, such as prescription drugs, rehabilitation facilities, or home health aids. Doing so will prevent you from switching policies or experiencing lapses in coverage.

For example, if you need long-term coverage, Tri-term insurance provides care for 36 months and is active within several days. Since this plan depends on your health status and ends at age 65 (when you’re eligible for Medicare), it may not be your best option. 

Learn About Copays & Deductibles

Selecting a healthcare plan for seniors can be complicated. But copays and deductibles may be a deciding factor. If you are low-income, you should choose a provider with fewer copays. 

In fact, Medicare caters to seniors with limited financial options. For instance, Part A (hospital insurance) has no deductible for hospice, inpatient hospitalizations, and stays at skilled nursing facilities. However, Part B (medical insurance) has a once-a-year deductible of $226 and a required monthly payment of $164 or higher, given your income. 

Choose Plans With Lifetime Renewability Option

To ensure your health insurance remains ongoing, you can search for providers with lifetime renewability. The renewability clause allows you to continue your plan for your entire life, which is an excellent option for those with chronic diseases or illnesses.

Find A Healthcare Advocate

Having a healthcare advocate can be great for navigating healthcare and insurance. They can assist with communicating your health concerns, medical treatment, and health insurance paperwork. 

If you are struggling with early-onset dementia and will lose the ability to convey your healthcare needs effectively, an advocate will prevent miscommunications from occurring. But it’s best that you find someone who is trustworthy and experienced in healthcare advocacy to ensure your safety. 

Living Will/Advanced Directive

Regarding healthcare for seniors, living wills are helpful. Advanced directive/living wills are legally binding statements expressing your wishes in case of an accident or injury. For example, they will clarify how to execute your requests if you don’t want to continue treatments when brain activity is lost. 

Lastly, these documents will guide family members and advocates with insurance matters and avoid stress caused by lack of preparation for terminal conditions. 

Best Health Insurance Options For Seniors 

Medicare 

Medicare is a government program for eligible seniors aged 65 and up. So, if you begin receiving retirement benefits between ages 62 and 65, you will be automatically enrolled in original Medicare (Part A and B). 

Recently, Medicare has expanded to four parts. Part A covers short-term hospital stays and emergency care. Part B covers general medical costs, specifically those deemed “medically necessary” by a doctor. Medicare Part C (Medicare Advantage) combines the benefits of Part A and B, reducing out-of-pocket costs and regular care with in-network physicians, while Part D covers prescription drug costs. 

Medicare Advantage improves the original plan by managing the costs of other services, such as fitness programs, vision, dental, and hearing. However, selecting a new policy means that your monthly premiums will increase. Therefore, this is more geared towards Seniors with higher incomes. 

Medicare supplements, or Medigap, provide additional coverage. Sold by private insurance companies, you must pay to fill in the gaps. Specifically, there are ten other plans to choose from. Some options cover nursing care facilities, hospice, and hospital stays, among many others. 

With either choice, you will reduce your costs, which is advantageous for seniors with a limited budget. 

Medicaid

Medicaid is a joint federal and state insurance program that covers medical costs for low-income people. Low-income families (seniors included), pregnant women, children, and individuals receiving Supplemental Security Income (SSI) are examples of mandatory eligibility groups. Compared to Medicare, Medicaid holders usually don’t pay for covered medical expenses but may owe a small co-payment for some items or services. With Medicare, members are responsible for partial costs through monthly medical and drug coverage premiums, deductibles, and coinsurance.

In addition, Medicare-enrolled seniors with limited income and resources can receive help with deductibles and out-of-pocket expenses. In other words, Medicare and Medicaid work together to provide more insurance coverage for seniors. Specifically, Medicaid provides health coverage to 7.2 million low-income seniors also enrolled in Medicare

Long-Term Insurance

Long-term insurance differs from traditional plans because they cover your long-term needs with the expectation of aging and disability. Services include custodial and personal care. If you are wondering what factors affect costs, premiums depend on various components such as age, gender, health, etc. Average costs for women and men between 50 and up range between $90 to $150 per month.

The only downside is that long-term plans can be expensive. For example, if you are looking into nursing homes, costs range between $90,000 and 125,000 per year. So, if you lack the funds to afford this option, home care is significantly cheaper.

How To Make The Right Healthcare Decision As A Senior

Choosing healthcare plans for seniors doesn’t have to be frustrating and confusing. At My Healthcare Direct, our private insurance agents will take the time to explain your options based on your current health condition and income status. Our highly experienced professionals will provide senior citizens with accurate and reliable advice regarding: 

  • Monthly deductibles
  • Which insurance suits you best
  • How to navigate healthcare and insurance services
  • Supplemental plans
  • Medicare
  • Medicaid
  • Medigap
  • Medicare Advantage

Contact My Healthcare Direct for more information and to begin searching for health insurance. 

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