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AliciaRusso Asked May 2018

Are there decent, affordable health insurance options for seniors with limited finances?

An elderly friend has recently fallen and fractured her hip. She is unable to afford a decent rehabilitation facility or an in-home nurse while she recovers. She has insurance and Medicare through Kaiser Permanente, but we're realizing her care and coverage options are very limited and we're worried about what could happen as she continues to age. Does anyone else have suggestions about other affordable health insurance options or where I can find reliable information?

vegaslady May 2018
I think she has a Medicare Advantage plan thru Kaiser. It would be illegal to sell her a Medigap plan in addition to a Medicare Advantage plan.

MaryKathleen May 2018
Check with your county Office on Aging. I went to my first Caregiver Support meeting there and the speaker discussed this topic. Also, I recommend a certified Elder Care Attorney (is that the proper term?).

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TNtechie May 2018
Does your friend have Medicare Part B? I believe you are asking about Medicare supplemental insurance plans that help cover costs that Medicare does not and often offer a few more benefits. You must have Medicare Parts A & B to purchase supplemental insurance. Here's a link for the Medicare info on supplemental insurance - www.medicare.gov/supplement-other-insurance/medigap/whats-medigap.html.

Medicare defines a set of supplement plans with _minimum_ requirements so that you can compare pricing (see the "How to compare Medigap policies" from the above link). Company A's plan F must contain the same minimum requirements that Company B's plan F contains. Company B may add benefits over the minimum but it must meet the minimum. One benefit in my parent's plan was an increase in skilled nursing care days from 100 (on medicate) to 365 with supplemental insurance. There was also a big increase in rehab days and maximum costs (but I don't remember those numbers).

Prices vary widely for these plans between companies. Your friend may have to "qualify" for supplemental insurance or she may want to qualify for a reduced rate. Many plans have an increase in premium with each year of age - many have a cap on how much the premium can increase. At 80, my mother's plan was around $200 a month, but my father's plan was nearly $300 from the same company because my father's health didn't allow him to qualify for a reduced rate. I chose plans with higher premiums but limited co-pays because I felt that was a better strategy for people on limited incomes. Plans with higher co-pays and maximum annual expenditures may have lower premiums but one good hospital stay can cost thousands.

Once you have a supplemental plan, you can keep it as long as you pay the premiums - you do not have to re-qualify unless you want to switch companies.

jjariz May 2018
It sounds like you're looking for Long Term Care, not Health Care. Long Term Care is self-pay. People without resources rely on Medicaid (not Medicare).

needtowashhair May 2018
Medicaid.

MrsWright37 May 2018
Does she have any type of long-term care insurance? If so, now would be the time to make a claim.

freqflyer May 2018
Alicia, check with your State Medicaid [which is different from Medicare] to see what insurance programs they have available.

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