You may assume that if your parent is over 65 years of age that they are automatically covered by Medicare or some other government health insurance program. But you should know that not everyone is eligible for these health coverage benefits, especially a spouse that stayed at home rather than worked.
If you find yourself in a position where you need to obtain health coverage for your parent, you may have more challenges than you think. Although the Affordable Care Act is still in force and there are many benefits for older Americans, your parent must still meet some minimum eligibility criteria to utilize those benefits. Furthermore, the ACA still permits insurers to charge more for older policyholders, so it will almost assuredly be more expensive for them.
Government Health Coverage
If you are looking for health insurance for your parent, the first place you should start is at Medicare. Medicare is available to all Americans aged 65 or older who paid Medicare taxes for at least ten years. Most non-working spouses do qualify for at least partial Medicare coverage as long as their spouse was gainfully employed and paid Social Security and taxes. In most cases, an older non-working spouse may still enroll in Medicare, even if the younger spouse has not yet enrolled.
Traditional Medicare has Part A and Part B. Part A covers inpatient services, while Part B covers outpatient services. If you or your spouse paid ten years’ worth of Medicare taxes, then you may enroll in Medicare Part A without paying a premium. However, Part B will cost you a small amount, which is deducted from your Social Security benefits every month.
There is a Medicare Part D which covers some or all of the costs of prescription drugs. This is a voluntary program that seniors may enroll in, but there is a monthly premium. There are many types of Medicare drug plans, so your parent should examine all of the available options to see which cover their medications and meets their financial needs.
For many seniors, the best choice for health coverage is not traditional Medicare, but rather Medicare Advantage. Medicare Advantage has all of the benefits of traditional Medicare, but because it is offered through private insurers, there may be additional benefits like vision, dental or prescription drugs. Most of the monthly premium is paid by Medicare, but some MA plans may ask for a small payment from the policyholder.
Another government insurance program you may wish to consider enrolling your parent in is Medicaid. Almost 4.6 million low-income seniors receive benefits from Medicaid, and almost all of these are simultaneously enrolled in Medicare. Medicaid may provide additional financial assistance in paying for Medicare premiums and out-of-pocket expenses.
If your senior parent does qualify for Medicare, you may feel that your financial troubles are all taken care of. The truth of the matter, however, is that your parent may still be responsible for a sizable part of their medical expenses. Part B of Medicare only pays 80 percent of approved services, leaving almost one-fifth of all medical expenses your parent’s responsibility. This can be an enormous financial burden for someone with only Social Security as their income. If your parent is unhealthy, then these expenses can quickly pile up, until it overwhelms them.
That is why the insurance industry created Medicare supplemental insurance. For only a modest payment each month, your supplemental policy may cover many out-of-pocket expenses like copayments and deductibles. To enroll in a Medicare supplemental insurance, you must be enrolled first in Medicare Part A and Part B. Medicare Advantage enrollees cannot take out a Medicare supplemental insurance policy.
In addition to Medicare supplemental insurance, you may wish to consider other types of supplemental insurance that offer important health benefits. For example, seniors often need vision, dental or long-term care, but these benefits are not included in traditional Medicare. For only a few dollars a month, you may obtain a supplemental policy that offers fuller health coverage for your aging parent.
Finally, you may wish to consider specialized health plans that offer additional financial protection in the case of cancer, heart attack or stroke. Almost a quarter of all deaths in the U.S. were due to heart disease, and a similar amount died from cancer. Stroke is the fifth leading cause of death in the nation. If you have family members that have encountered these health problems, then it may be a good idea to take out a policy that covers these contingencies. Many of these specialized health policies offer a lump sum payment that you can use on medical services, travel or basic living expenses.
Private Insurance Policies
If your parent wants to obtain health coverage through a private insurer, then one of the best options is through one of the Obamacare health insurance marketplaces. If they are not enrolled in other insurance programs like Medicare and they meet certain income requirements, then they may qualify for premium tax credits. These premium tax credits may take hundreds of dollars off of their monthly premium payments.
Even if your parent doesn’t meet the eligibility requirements for premium tax credits, they may still be able to find quality health plans at reasonable rates. In recent years, there has been a decline in the number of health plans found on the Obamacare exchanges, but every county in the nation had at least one plan available.
If you are unable to find a health plan on the exchanges that meets your needs, you may, of course, approach an insurance agency. You will often have a choice between insurance agents and insurance brokers when you are shopping for a policy. You should keep in mind that insurance agents work directly for insurers and are therefore, more likely to offer you insurance policies from their employer, while an insurance broker is an independent intermediary. Brokers like Boost Health Insurance are more likely to offer a wider range of policies from a number of private insurers.