Over 55? You Can’t Live Without This

Photo of elderly couple sitting outsideAging is inevitable, and in today’s modern society, people are living longer than ever.

Right now, there are close to 600 million senior citizens in the world, a number that will continue to grow. Access to healthcare is one reason we are living longer and as you get older, the need for quality senior health insurance grows.

There are several options that people over 55 can use but finding the right coverage can be tricky.

Our Aging Population

  • In 2010, there were 40 million people 65 and older living in the United States
  • By 2030, the 65+ population will grow to more than 72 million people
  • Only 11% of elderly people participate in exercise to strengthen muscles
  • 38% of senior citizens are obese

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Elderly Health Care Options

As a senior citizen, you can have access to several different methods for getting senior medical insurance. With the rising cost of healthcare, having just one plan may not provide the coverage you need. As you age, you can become increasingly prone to disease and injury, so it’s important to be properly protected.

Many adult children assist aging parents in the search for senior health insurance, so understanding the options is essential for everyone involved.

The following are some of the most common forms of health insurance for senior citizens:

  • Medicare
  • Medicaid
  • Private health insurance
  • Medicare supplemental insurance

Each of these is described in more detail below.

Medicare

Medicare is a federal health insurance program for people age 65 and older, as well as people with disabilities and severe health conditions. It is divided up into four different parts:

  • Medicare Part A, also known as hospital insurance, will cover hospitalization and home healthcare. This is free if you’ve worked for 10+ years and paid social security taxes. You will need to fill out an application for Medicare in order to be covered.
  • Medicare Part B includes medical insurance. This will cover a range of medical services like doctor’s visits and annual check-ups, mental healthcare and x-rays. As with all plans, there are coverage limits, and this option isn’t free. The annual premium for Part B is $104.90 and you are automatically enrolled when you become eligible for social security.
  • Medicare Part C is known as Medicare Advantage. It allows you to get Medicare coverage through private companies. The advantage of Medicare Part C is that it often provides better coverage, but you must have Part A and B to be considered eligible. Costs vary according to state and providers.
  • Medicare Part D covers prescription drugs. You don’t have to enroll in this part of Medicare, but if you take regular medication, it might be a good idea for you to pursue it. This also comes with a monthly premium based on coverage amount.

Medicaid

This federal program provides medical insurance for low income seniors often used in conjunction with Medicare. It will provide coverage for certain medical services and prescriptions. There is an application process you’ll need to go through, and you need to meet certain income limitations to qualify. If you qualify for Medicaid, it’s a good method to get affordable senior citizen health insurance.

Private Health Insurance

If cost isn’t a factor and you are trying to find health insurance for elderly parents, a private health insurance plan can be paired with Medicare. This is a good way to make sure you are completely covered as Medicare does have limitations. Be sure to check your private plan to understand the exclusions on that policy and avoid gaps in coverage.

There is one big disadvantage that senior citizens may face when searching for private senior health insurance: pre-existing conditions.

Seniors with pre-existing conditions should be able to find coverage with the passage of the Affordable Healthcare Act. If you need a private health insurance plan, there are options available right now, but hopefully the future will bring more affordable options to all seniors.

Medicare Supplemental Insurance

Medicare supplemental health insurance, called “Medigap” is meant to provide coverage for the things that Medicare doesn’t cover.

To qualify for Medigap, you must be enrolled in Medicare Part A and Medicare Part B. Your Medigap coverage will help cover excess costs, such as co-insurance costs for stays in the hospital or a nursing facility, and even the deductibles in your Part A and Part B Medicare plans.

You can find this plan through private insurers and organizations that cater to the elderly. Costs will vary according to coverage.

Buying the Right Health Insurance for Elderly People

With all the various options that are available and the many combinations, finding the right senior health insurance can be confusing. It’s a good idea to familiarize yourself with federal insurance programs and to examine private policies as well.

Under the Affordable Care Act, you’ll be able to search for policies that meet your needs on an online marketplace. Each state will have a marketplace (or, if your state does not have its own marketplace, it will be run by the federal government), so everyone will have access.

Remember that you are encouraged to ask questions of your potential insurer, and to advocate for yourself to make sure you’re getting the coverage that makes the most sense for your needs. Our independent agents are available to answer your questions and to provide the information you need. Contact us today.

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Find Insurance for Pre-Existing Conditions

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Photo of many types of pillsThe search for the right health insurance can be a frustrating process, but if you have a pre-existing condition, it can be even more challenging.

It all comes down to the fact that a person with a pre-existing condition is a higher risk, and therefore more expensive to insure. You may have been denied coverage entirely, or your coverage may be more costly than you would like.

If you’re having trouble finding insurance for pre-existing conditions, contact one of our local independent agents in the Trusted Choice® network. Because our agents have access to many different insurers, they can quickly browse offerings from different health insurance companies to find a policy that offers insurance for pre-existing conditions.

Facts About Pre-Existing Conditions

  • Examples of a pre-existing condition include heart disease, high blood pressure and asthma
  • 21% of people with pre-existing conditions are rejected or charged a higher premium for individual health insurance
  • In 2014, the Affordable Health Care Act will make it illegal for insurance companies to deny or charge higher premiums because of pre-existing conditions

What Are My Options if I Have a Pre-Existing Condition?

If you have a health plan through your employer, insurance that covers pre-existing conditions will be easier to find. Group policies cannot deny coverage even if you have a history of serious medical conditions. Not everyone can receive employer-sponsored insurance, however. If you have to find individual health insurance with a pre-existing condition, it may be a difficult search.

Some insurance companies offer what is known as a CSD, or condition-specific deductible. This allows you to receive normal healthcare coverage with a normal deductible for everything except your specified condition. Your insurance for pre-existing conditions will have a separate deductible amount which is offered in amounts from $2,500 to $15,000 depending on providers. This may be a better option for you than having your specific condition completely excluded from a policy.

Consider contacting an independent agent who can help you understand how different plans will affect your pre-existing condition and which one is ultimately your best choice.

What Is a Pre-Existing Condition Insurance Plan (PCIP)?

If you’re denied health insurance due to a pre-existing condition and haven’t had coverage for at least 6 months, the pre-existing condition insurance plan is a federally funded plan that may help. This plan covers primary, specialty and hospital care as well as prescription drugs. Depending on where you live, program rates may vary.

At this time, the PCIP is not accepting new applicants. Typically, those enrolled through this program have expensive medical needs and the program receives a limited amount of government funds. The program ceased taking new applications in 2013 in order to make sure that over 100,000 people continue to receive benefits through that calendar year.

While it’s possible that this federal insurance plan may re-open in the future, if you need insurance coverage now, there are several things you can do. Read on to find some tips on getting insurance for your pre-existing condition.

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Tips for Finding Insurance for Pre-Existing Conditions

  • Start a business: If you run your own business, in some states, insurance companies will consider you a group. Through group insurance plans, you cannot be denied based on pre-existing conditions (or the denial may only last a short period of time). Check your state for specific laws.
  • Use COBRA: If you’ve lost your job, consider investing in COBRA. While it is expensive, it will buy you time and keep you insured while you search for new coverage. Typical coverage is up to 18 months but don’t let much time pass between COBRA coverage and your new policy. After 63 days of being uninsured, you have a significant gap in coverage which can make it much more challenging to get a new policy.
  • Join a high risk pool: Check to see if your state has a high risk pool, which is for those who have difficulty finding affordable insurance due to severe health conditions. Rates will typically be higher, but it may be worth it to ensure that you have the healthcare coverage you need.
  • Apply for government aid: Programs such as Medicaid may be able to offer relief to low and moderate income families

The Future of Insurance and Pre-Existing Conditions

As of 2014, people who seek insurance for pre-existing conditions will be able to find affordable coverage for the first time. With the passage of the Affordable Care Act, it will be illegal for insurance companies to charge higher premiums for pre-existing condition insurance plans, or to deny coverage. Insurance companies will not be allowed to exclude coverage for a specific condition and cannot set a dollar limit on the amount of benefits provided.

To get a complete understanding of your health care options, contact one of our independent agents in the Trusted Choice network who specializes in health insurance. You can gain more control over your situation by exploring and leveraging all the options available.

Our agents will work one on one with you to help you find the right insurance for your pre-existing condition that fits your specific needs.

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