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Does Senior Healthcare Have Room for Seniors without Medicare?

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senior healthcare without medicare

Health insurance has seen some major changes in the U.S. over the last several years – including changes made to Medicare. These changes have made healthcare more widely available – and at more competitive rates – for a large portion of the population. As these options have expanded, those looking for senior healthcare have been given some new options both within and outside of Medicare.

If your loved ones are able to afford non-Medicare insurance for their senior healthcare, there are quite a few options available to them should they choose go that route. If not, Medicaid can provide coverage for those who do not want or may not qualify for certain parts of Medicare. It can be a bit confusing, and a bit overwhelming, so research now can save you from undue stress in the future.

  • Public Health Care - The most predominant option available is Medicaid, the government controlled health care program designed for those who cannot afford regular health care.
  • Private Health Care – This includes a fairly wide range of options, the most prescient being Medicare Advantage and privately purchased insurance like Indemnity plans, Preferred Provider Organization Plans (PPO Plans), Health Maintenance Organization Plans (HMO Plans), and Point of Sale Plans (POS Plans), which are a hybrid of HMO and PPO plans.

Public Health Care

States decide what coverage is available under Medicaid, the most common form of public healthcare available not only to seniors, but people of all ages. Its function is to provide healthcare for low-income children and families, as well as seniors. Doctor’s visits, hospital care, vaccinations, prescription drugs, vision, hearing, long-term care – which is important for senior health care in general – and preventive care are all common facets of Medicaid care. While this can provide coverage for your loved ones on its own, it is commonly used in conjunction with Medicare as a supplement, helping to fill in the gaps in Medicare coverage.

Private Health Care

Senior healthcare can be costly, as any number of issues can arise during their later years. While most seniors opt in to Medicare coverage, there are still options available for those who do not wish to utilize those benefits.

Medicare Advantage offers many benefits that regular Medicare does not, acting as a privatized version of Medicare while behaving more like a non-Medicare, privately purchased plan. However, it is important to note that the difference in copayments, premiums, and other kinds of fees is significant, so researching the version of Medicare Advantage your loved ones wish to purchase is necessary to make sure they’re getting the most out of their plan, while at the same time they’re not faced with exorbitant fees and restrictions they were unaware of. As well, regardless of the plan that is purchased, changes are regularly made to “in network” doctors, while medications that may have initially been covered may change or disappear altogether.

PPO plans offer services from specific healthcare providers – doctors and healthcare facilities they have entered in to a contract with in order to secure lower rates, while HMO plans allow you to choose a primary care physician (PCP) within their established network providers. Your PCP is responsible for all of your healthcare and must refer you to others in order for you to receive outside care. POS plans are a hybrid of HMO and PPO plans and offer a bit more flexibility, though have restrictions of their own.

Before They Make a Choice

Researching the options your loved ones have is one of most sensible things you can do, both for them and yourself. Understanding the subtle and not-so-subtle differences in these plans now can help you make the best decision possible later.

Bryan Reynolds
By
March 08, 2014
Bryan Reynolds is the Vice President of Marketing and Public Relations for Episcopal Retirement Services (ERS). Bryan is responsible for developing and implementing ERS' digital marketing strategy, and overseeing the website, social media outlets, audio and video content and online advertising. After originally attending The Ohio State University, he graduated from the College-Conservatory of Music at the University of Cincinnati, where he earned a Bachelor of fine arts focused on electronic media. Bryan loves to share his passion for technology by assisting older adults with their computer and mobile devices. He has taught several classes within ERS communities as well as at the Osher Lifelong Learning Institute run by the University of Cincinnati. He also participates on the Technology Team at ERS to help provide direction. Bryan and his wife Krista currently reside in Lebanon, Ohio with their 5 children.

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