Unforseen gaps in insurance under Medicare Parts A and B are far from new. But what can be done to protect from it? With more time that passes, these sorts of battles aren’t just for padding a bank account. They can mean the difference between life and death for seniors in need of crucial care. As a resident of Minnesota, you face some challenges that most other seniors may not when it comes to choosing the most cost-effective health care for you.
Senior Medicare in St. Paul: Facts and Figures
- There are 29,846 senior citizens living in St. Paul right now
- There 10 hospitals in the St. Paul area where seniors can get emergency and/or in-patient care
- 56% of MN seniors have a Medicare Advantage plan
- 21% of seniors have a Medicare Supplement (Medigap) plan
- Which leaves 23% of seniors potentially uninsured or underinsured against costly Medicare coverage gaps!
Many seniors are afflicted with particular types of disease as they reach a certain age. Unfortunately, these tend to be the variety which are lingering and persistent, requiring care from diagnosis to end of life. Many can worsen over the passage of time, making medical costs skyrocket as the years pass. There is substantial evidence to suggest that seniors will likely suffer more than just one of these ailments at a time, too. That means costs doubling and tripling in a blink. Here are the more prevalent chronic diseases in St. Paul.
|Disease||Prevalence (in St. Paul)|
|High Blood Pressure||24%|
|Coronary Heart Disease||5%|
Healthcare Costs in St. Paul, MN
Of course, it is vital to understand how expensive these diseases are to treat. Prescriptions, medical equipment, in- and out-patient care, doctor appointments; it all adds up. Not to mention, all medical costs in general are on the rise every year. A doctor’s appointment today is more expensive than the same doctor’s appointment at the same office with the same doctor this time last year. The upside is, thanks to advancing medicine, seniors are living longer. But they’re also incurring more and more medical debt. This means it is more important now than ever before to ensure your coverage is up to snuff going into your senior years.
|Disease||Prevalence (in St. Paul)||Annual Cost of Treatment|
|High Blood Pressure||24%||$356|
|Coronary Heart Disease||5%||$9,064|
Medicare Advantage Savings in St. Paul, MN
The federal government has approved Medicare Advantage, which is a non-government administered private health insurance plan. The costs of your individual insurance are not directly paid for by the government, but instead the government pays their share towards your monthly premium and you pay the remaining medical costs on your own. Legally, your insurance must cover at least the identical benefits you would get if on state-mandated Medicare Parts A & B. Most non-government insurers add additional benefits like vision or dental, for a premium.
Medicare Advantage plans offer better coverage for the needs of seniors with these common chronic illnesses, according to the statements of those seniors themselves. Every illness, but especially those that are long-term and near the end of life, requires consistent management to alleviate symptoms and ensure a good quality of life. This can include prescriptions, testing items, frequent doctor visits, and more. As these conditions worsen, costs still continue to increase. Fortunately, there are Medicare Advantage plans which can cover even more than a traditional Medicare plan, even when said Medicare plan includes extras like Part D. To be ready for your remaining future, you have to prepare beforehand with Medicare Advantage.
Medicare Advantage can cover even more than Original Medicare Parts A and B. Doctor visits, testing equipment, and drug plans are options as well. Many plans allow the option to add vision or dental coverage for additional premium costs. Thanks to the government paying some or potentially all of the premium, seniors can get a fully comprehensive Medicare Advantage plan starting as low as $0 a month out-of-pocket for premium cost. There will still be certain items that insurance doesn’t cover, like copays or coinsurance, which will be the responsibility of the plan holder.
Medicare Supplement (Medigap) Savings in St. Paul, MN
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 get treatments for 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.
Medigap Plans A, D, K, and L are the ones designed to cover the pricy costs for the lack of coverage in Medicare Part A. The other Medigap plans have Part A coverage as well, but include extras that we’ll touch on in a minute. If Medicare Part B costs aren’t something you need to protect yourself against, you then shouldn’t feel the need to purchase them, thus saving you more premium. If hospital stays from Part A is your concern, Plans A, D, K, and L are the ones you may wish to consider first.
Other Medigap plans available are Plans B, C, F, G, M, and N. They cover Medicare Part A costs as well as differing portions of Part B. The more coverage your plan provides, the more the monthly premium will cost. But, this also means far fewer out-of-pocket surprises when situations arise, both for Medicare Part A and Medicare Part B. A few dollars more in premium payments could save potentially thousands in medical bills. It is worth noting that Plan F will be retiring at the end of 2020, and you cannot enroll in it after December of 2020.
There are gaps in Medicare Part B as well to take into consideration. Part A is supposed to take care of hospital visits and inpatient care, and Part B should, in theory, take care of the rest. This isn’t always how things work, however. Copays and coinsurance remain the responsibility of the insured, as usual, and can add up to a considerable amount over time. There are a variety of different plans which can compensate for this so that patients like you don’t get overwhelmed with too many medical bills.
Medicare Advantage offers plans which cover incidental costs with prescriptions, dental, or vision coverage. Medicare supplement (or Medigap) plans do not. Medicare itself does give the option for Part D coverage which is very inclusive for many types of prescription medications. A quick online search can uncover excellent local sources of dental or vision insurers which offer discounts to seniors.
For all seniors in St. Paul, 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.
|Medigap Plan||Minimum Monthly Premium||Maximum Monthly Premium||Average Estimated Monthly Premium (Part B Premium Included)|
|Medigap Basic Plan||$121||$269||$331|
|Medigap Extended Basic Plan||$185||$597||$527|
|Plan F (high deductible)||$53||$121||$223|