Senior health insurance starts with the Medicare benefits provided by the federal government.
The good news is that Medicare benefits pay for the majority (but not all) of most senior’s medical bills. The not so good news is that Medicare does not pay for everything. Uncovered medical expenses typically fall about about 20% short; and with those expenses frequently running into thousands and even hundreds of thousands of dollars, uncovered medical expenses can be a VERY BIG number.
Fortunately, in addition to Medicare, there are several low-cost and possibly no-cost government funded health insurance options. ACCESSMed’s mission is to help Arizona’s approximately 500,000 seniors, who are living on limited incomes, understand and enroll in their best Medicare benefits options.
Original Medicare is made up of two parts. Medicare Part A covers hospital insurance. Part B covers medical expenses such as doctor visits, lab work and some personal medical equipment.
Original Medicare typically covers about 80% of Part A and Part B expenses. Patients are responsible for the remainder of their medical expenses, including prescriptions.
Seniors who select Original Medicare also have the option of selecting an additional private insurance plan to cover their prescription drug expenses, or a more comprehensive Medicare Insurance Supplement plan (known as a Medigap plan) to fill in the “gaps” in their hospital and medical expenses that Original Medicare leaves uncovered.
Read more about Medicare.
In addition, it may be worthwhile considering these additional options:
Option 1: AHCCCS Medicaid
In Arizona, AHCCCS Medicaid is a joint federal and state health insurance program that serves vulnerable seniors and some other individuals with health insurance coverage. When AHCCCS Medicaid can be combined with Medicare Advantage benefits, the combination provides a wide range of medical and related services at little and possibly no cost.
In Arizona, qualified individuals can sign up for a Medicare Advantage plan when they enroll in Medicaid. This dual coverage is referred to as a Special Needs Plan.
Read more about AHCCCS Medicaid.
Option 2: Medicare Advantage
Despite the fact that most seniors are living on limited incomes, many have just a little bit too much income to qualify for AHCCCS Medicaid. For these individuals, a Medicare Advantage plan is the next best option.
In addition to being economical, many Medicare Advantage plans combine medical coverage with additional benefits including routine vision care, hearing aids, routine dental care, prescription drugs and fitness center memberships.
Read more about Medicare Advantage.
Option 3: AHCCCS Medicaid And Medicare Advantage
It may be possible to combine AHCCCS Medicaid with Medicare Advantage coverage. These coordinated programs are referred to as Dual Special Needs plans. These plans provide comprehensive low-cost and possibly no-cost coverage for prescription drugs, vision and dental care, over the counter health products and equipment, meals and transportation to health care appointments.
Read more about AHCCCS Medicaid + Medicare Advantage.
Option 4: Home Health Insurance
Home care services are non-medical in nature and typically support elderly individuals by helping them with day-to-day tasks in their own home. A home health aide can help you bathe, use the toilet, take drugs and do other daily activities.
Medicare will only cover the cost of these services if you are also concurrently receiving skilled nursing or rehabilitative care. Otherwise, Medicare does not pay for non-medical home care. Medicaid may pay for some home care expenses for individuals who are otherwise medicaid qualified.
Read more about Medicare and Home Health Insurance.