Insurance Options for Seniors

The Healthy Aging Program at Atlantic Health System suggests the following helpful resources to help seniors find information on Medicare, Medicaid and long-term care insurance.

Medicare

Medicare is a joint federal-state funded government health insurance program for people age 65 or older, as well as many people living with disabilities. It consists of the following parts:

Part A
– Medicare Part A (hospital insurance) covers hospital care, some skilled nursing and sub-acute inpatient care, and some home health and hospice care. The majority of people on Medicare have Part A.
Part B
– Medicare Part B (medical insurance) helps cover doctors' services, outpatient hospital care, and some other medical services that Part A does not cover, such as physical and occupational therapy. Part B helps pay for these covered services and supplies when they are medically necessary. Most people have their monthly premium for Part B deducted automatically from their Social Security checks.
Prescription Drug Plans
– Also known as Medicare Part D, Medicare Prescription Drug Plans are stand-alone insurance plans that provide prescription drug coverage. Like traditional insurance companies, you use a member ID card that you get from the plan when you go to the pharmacy. Your costs will vary depending on your financial situation and which Medicare Prescription Drug Plan you choose. If you have limited income and resources, you may be eligible to get extra help to cover prescription drugs for little or no cost.
Medigap
– A Medigap policy is health insurance sold by private insurance companies that helps pay some of the health care costs that Original Medicare doesn’t cover. If you have traditional Medicare and have a Medigap policy, then Medicare and your Medigap policy will pay both their shares of your covered health care costs. Generally, when you buy a Medigap policy you must have Medicare Part A and Part B. You will have to pay a monthly premium to the Medigap insurance company in addition to your monthly Medicare Part B premium.

Medicare Advantage Plans

A Medicare Advantage Plan (like an HMO or PPO), sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. These plans provide Part A and Part B coverage, may include prescription coverage (Part D) and offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services, like whether you need a referral to see a specialist or if you have to go to only doctors, facilities, or suppliers that belong to the plan.

For general information about Medicare and up-to-date information regarding the health plans available in your area, call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, seven days a week.

Medicaid

Medicaid provides health insurance to people who are aged, blind or disabled who meet specific standards for financial income and resources. It pays for hospital services, doctor visits, prescriptions, nursing home care and other health care needs. To apply for Medicaid, contact your local county Board of Social Services office:

Long-Term Care Insurance

Long-term care insurance is a policy you pay for that will provide some coverage for extended health care in assisted living facilities and nursing homes. Medicare and most Medigap insurance policies do not pay for extended health care in facilities such as assisted living or skilled nursing facilities/ nursing homes. Some people purchase long-term care insurance to help supplement the cost of their care. Premiums range in monthly cost and the range of coverage can depend on the level of care the policyholder chooses.

General Insurance Information

Doctor reviews health resources with patient