How Poverty Affects Older Adults
Believe it or not, poverty has been reported as a health issue amongst seniors, with 45 percent of adults ages 65 and older being considered impoverished, falling below the poverty level. This is according to a 2015 Kaiser report. The main contributing factors to this number include the availability of financial resources, financial liabilities such as cost of living, the demand for benefits like food stamps and Medicaid, and medical expenses. The report states that older women are slightly more likely than older men to live in poverty amongst this age group, especially women over 80 years old.
Proper healthcare begins with having the financial means to obtain appropriate healthcare services. This includes being able to afford life-saving preventative and diagnostic services, which continue to be a strain, even for those adults who receive no-cost Medicare Parts A and only pay for Medicare Part B. There is another group of seniors who don’t qualify for no-cost Part A and have to pay for both part A and part B. Those seniors are either paying out of pocket for everything or are just not receiving any medical care. This financial deficit is widespread amongst seniors who may not be aware of programs that provide benefits to alleviate some of these health concerns.
Medicare has made significant strides in providing access to affordable care for seniors. In addition to the renowned part A and Part B benefits, part C or Medicare Advantage plans create a noticeable difference in the affordability, accessibility, and scalability of the medical services and benefits available in most areas across the United States.
Part C Coverage
Medicare Advantage plans or Part C are “all-in-one” plans that bundle your Medicare Part A, Part B, and Part D (prescription drug plan) into a Medicare Advantage plan with prescription drug coverage or “MAPD” plan. When you join a Medicare Advantage plan, you still have Medicare Parts A and B in addition to benefits like a gym membership, home-delivered meals, Part B giveback on social security check monthly, hearing, dental, vision, over-the-counter spending allowance, and much more. Most of these plans have a $0 premium, and all of them come with a maximum out-of-pocket limit that protects the number of financial risks you have with your healthcare needs and services.
Part C In Perspective
Medicare Part C puts a limit on the out-of-pocket medical expenses that you have when you have Medicare. Without Medicare Part C, Medicare beneficiaries pay 20% of the cost for all medical services like doctors visits, specialist visits, outpatient services, medical supplies and durable medical equipment like a wheel chair or oxygen tank. In some cases, 20% may be manageable and Medicare recipients may be tempted to remain content in just having Part A and B, but that decision results in paying higher costs and coming out of pocket with more money for medical services.
A significant amount of Part C plans also provides preventative care services like cancer screening, depression screening, cardiovascular disease screening, diabetes screening and management and much more at no cost.
These plans increase affordability by putting an annual maximum out of pocket spending limit to protect you from strenuous healthcare risks that would otherwise be impossible for you. In addition, instead of paying 20% of your healthcare costs, you will only pay a small copay for most services and in some cases, you won’t have any copays at all.
These plans offer you flexibility in choosing to save more on out of pocket costs with a structured in network health plan or pay higher costs but have the freedom to see any doctor you wish anywhere across the United States. These are HMO plans and PPO plans. A Health Management Organization plan or HMO plan for short is a health plan that offers a designated network of doctors that you must see in order for the plan to pay benefits. If you go outside the network, you would foot the bill for any out of network services received. An HMO plan also requires you to get referrals from your primary doctor to see other specials, which many Medicare beneficiaries don’t like, but the cost of an HMO plan is generally less expensive and features higher benefit amounts than the alternative.
A Preferred Provider Organization or PPO plan is a health plan that gives you freedom to see any doctor or specialist locally or nationally, without needing a referral, but at a higher cost. These plans will have in-network and out-of-network options for healthcare services so you have the choice to pay lower copays by staying in the network.