Unforseen gaps in Medicare Parts A and B can be enough to send even the most well-saved retirees scrambling without the right gap coverage. So how can smart seniors keep their hard-earned funds in their bank accounts rather than having to use them for unexpected medical costs? This isn’t just a fight for some spare cash, but a fight for the lives of seniors throughout Hawaii. In Honolulu, there are assuredly more challenges than most other places in finding the right coverage.
Senior Medicare in Honolulu: Facts and Figures
- There are 173,474 senior citizens living in Honolulu right now
- There 11 hospitals in the Honolulu area where seniors can get emergency and/or in-patient care
- 45% of Hawaii seniors have a Medicare Advantage plan
- 2% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 53% of seniors potentially uninsured or underinsured against costly Medicare coverage gaps!
It is a sad truth that chronic ailments become more pervasive with age. It is simply what happens as the human body begins to cease functioning as well as it once did. Usually, these are the diseases which we carry for the rest of our lives, as well as the costs associated with them. As if that wasn’t difficult enough to handle, it is not just possible but likely that we may have more than one disease at a time. This could lead to outlandish medical expenses that could cripple even the most financially sound senior, if they are under- or uninsured. The chart below details the common chronic diseases among seniors.
|Disease||Prevalence (in Honolulu)|
|High Blood Pressure||31%|
|Coronary Heart Disease||5%|
Healthcare Costs in Honolulu, HI
We cannot talk about chronic disease without talking about money. Medicine, equipment, hospital care, doctor’s visits; they all add up quickly. And they keep adding up as more time goes on. Seniors are living longer lives than ever, which is fantastic. But that quality of life quickly diminishes when crushed under the weight of unending medical debt. Now is more important than ever to ensure you have adequate protection for the next phase of your life. Affordable, comprehensive, helpful healthcare coverage is the most important preparation.
|Disease||Prevalence (in Honolulu)||Annual Cost of Treatment|
|High Blood Pressure||31%||$288|
|Coronary Heart Disease||5%||$8,452|
Medicare Advantage Savings in Honolulu, HI
While Medicare Advantage is not government-issued, it is government-approved. Technically, Medicare Advantage is a separate, private insurance plan, but with very unique benefits. Insurance costs aren’t paid for by the government, but instead they redirect your intended costs to Medicare Advantage, and any remainder becomes the patient premium. This cost can be, in many cases, as low as $0 a month. Medicare Advantage must cover at least the same as Medicare Parts A & B, but many outside insurers offer add-on benefits for more premium.
Medicare Advantage plans can offer many seniors better coverage options for their chronic ailments. Diseases like diabetes, arthritis, and high blood pressure are generally progressive and last until end-of-life, plus require extra effort to manage. Drugs, tests, prescriptions, equipment, additional doctor visits; all of these things can and do culminate over time, resulting in a higher bill. Medicare Advantage can be more effective than just Medicare plans alone. Over time, as these conditions continue to get worse, bills will continue to pile up. Even with Medicare Part D, you can get more coverage and save more money with some Medicare Advantage plans. It’s important to start budgeting now for the inevitable cost.
A cost effective drug plan is only part of what can be added to Medicare Advantage plans. Doctor appointments, equipment of the medical or pharmaceutical variety, and an economical prescription system, are all options for different Medicare Advantage plans. Even more give the choice to incorporate dental or vision benefits into their packages, as an extra boon. The federal government which would be providing Medicare then instead redirects the funds to the Medicare Advantage plan of your choice. That means you could receive even more coverage for no additional cost! However, copays and coinsurance will still always be the responsibility of the policy holder. And with any insurance policy, there will be some expenses that just aren’t covered.
Medicare Supplement (Medigap) Savings in Honolulu, HI
There is another type of policy called Medigap, which is a Medicare supplement. They work a bit differently to a Medicare Advantage policy, but they can still save a great amount of money, particularly when covering gaps in Medicare Part A. The biggest chronic conditions, like coronary heart disease or kidney disease, can cost thousands just for the stay in the hospital and treatments while there. These stays can be incredibly long, and after a certain point, traditional Medicare stops coverage. You will have to have some sort of backup coverage, or face paying astronomical costs to continue care.
Currently, there are four different plans tailored for exactly the above coverages. These plans are: Plans A, D, K, and L. There are additional plans which cover gaps in Part A as well as gaps in Part B, but we will discuss those in a moment. For now, it is important to understand that if you do not need the gap coverage for traditional Medicare Part B, buying a supplement plan which only covers gaps in Part A will come with a lower premium, thus saving even more money.
However, if you anticipate needing help with the gaps in Part A and Part B, there are Medigap plans B, C, D, F, G, M, and N. These cover differing aspects of traditional Medicare Parts A and B. As always with any insurance, more coverage results in more premium payments. Still, it is important to note that this isn’t necessarily a bad thing. More coverage also means less out-of-pocket expenses, so paying a higher premium could actually save money in the long run. Plan F is only available for a limited time, as it will be retiring in 2021.
But what gaps are there in Medicare Part B? We know Part A is hospital stays and inpatient care, so what is left for B? Nearly everything else. Any outpatient procedures, specialist check-ups, medical or therapeutic gear, supplies or necessities. These are all supposed to be covered under Medicare Part B, but of course, there are always exceptions like copays and coinsurance. Still, there are Medigap plans designed to pitch in with those sorts of costs.
Medicare supplement insurance does not provide for Rx drugs, dental, or vision, unlike Medicare Advantage. However, Original Medicare does allow seniors to choose a Part D, which provides for prescription drugs and the associated costs. This is offered whether or not you choose a Medicare supplement insurance plan. With a little research, it is easy to find affordable dental and vision plans for seniors in your area. Discounts for the elderly are especially available in most locations.
For all seniors in Honolulu, it is of the utmost importance that you understand the principles and advantages of a supplemental Medicare health plan. These can be the difference between living through your golden years or having them rust and turn to bronze years. The rising cost of medicine and care is out of control, but what we can control is how we prepare to face the inevitable. You absolutely have to find a Medicare supplement policy that fits your needs, yet doesn’t break the bank. We want to help you do exactly that.