Caring for Aging Parents: How to Keep Expenses Low

Fran
Fran Majidi
November 11, 2019

Caring for aging parents is not for the faint-hearted. If you have aging parents and have been put in charge of handling major finances, like bills and medical care, you’ll find that your bills will primarily be for medical care and they will be exhausting.

According to a 2015 study, called Medical Spending of the U.S. Elderly, on average, people age 65 and up spend over $18,000 a year on medical expenses. Yes, your parents may qualify for Medicare, but did you know that there are many areas they won’t have coverage?

The elderly have the most expensive dental costs of anyone and Medicare does not cover dental visits, implants, and dentures. Also, copays add up, especially if your parents see several specialists a month. The cost of prescription drugs, as everyone knows, is also a big drain for older people. Are you prepared for this task you’ve been given?

Would you like to figure out how to save some money by comparing Medicare options?

What Is Medigap?

Medicare supplements are called Medigap. The definition of Medigap definition is a private individual plan that helps cover the costs not covered by Original Medicare, including copayments, deductibles and health care outside of the U.S. It does not usually cover prescription medication (Medicare Part D).

Medigap plans range in prices so it’s best to compare Medigap plans. Medigap is a coverage you can buy to supplement your Medicare coverage. However, you can only buy it with Original Medicare, not the private insurance alternative, Medicare Advantage. Agents are legally banned from selling both Medigap and Medicare Advantage to the same client. 

Medigap and Med Supps: What Do They Cover?

Medigap and Med Supps (Medicare Supplements) are all the same thing, so don’t get confused. The main reason people buy Medigap or Med Supps is to cover copays and deductibles, which do not apply to prescription drugs, only visits to healthcare providers. Just as you would if you had any type of private health insurance, you pay a monthly premium. In exchange, instead of paying copays out of pocket when your parents visit the doctor or any healthcare provider, insurance will cover it.

What Medigap Doesn’t Cover:

You’ll still be on your own with long-term care, dental care, vision, hearing aids, eyeglasses, and private duty nursing even if you have Medigap. Most plans also do not cover prescription drugs. If you want a comprehensive plan that covers these, you should consider a Medicare Advantage Plan (see below).

Why Would I Choose Medicare Advantage Over Medigap Insurance?

Medicare Advantage is the private version of Original Medicare but it is still monitored by the government and is required to offer at least as much as Medicare, which includes Part A and Part B of Medicare benefits. Each private health insurance company is different and it’s important to find the right Medicare Advantage provider, but for the most part, you can expect Medicare Advantage to cover more needs than Original Medicare, even if you buy Medigap insurance along with it.

Medicare Advantage vs Medigap

For one thing, as we mentioned above, dental issues are very expensive and not covered by Original Medicare. One set of dentures can cost thousands of dollars and may need to be replaced over time ($1,275 to $2,750). Implants usually cost more ($1,500 to $6,000 for just one implant with a crown and abutment!). As people age, their hearing deteriorates. Hearing aids are expensive and often need replacing (average prices range from $1,500 to $3,500).

Depending on your parents’ lifestyle and budget Medicare Advantage may be the perfect way to help aging parents financially. Do you want coverage for these expensive items or do you have enough saved to cover them? Which will cost you less? Medigap does not cover them either. Medigap (vs Medicare Advantage) would not pay anything towards the services listed above. It’s a good idea for you to sit down and go over the prior year’s healthcare expenses and see which plan would better serve your parents.

Medigap Plan F: What Is It?

Medigap Plan F is the most comprehensive benefit of all Medicare Supplement policies. It covers copays and deductibles for Part A and Part B. It also covers Skilled Nursing Facilities (SNF) coinsurance. It also covers foreign travel emergencies (unlike Medicare Advantage that will cover any medical need abroad). Medigap Part C and Part G are the next most comprehensive Med Supp plan available. It’s important to compare your Medigap options with a trusted agent because there are several.

Does Medicare Cover Nursing Home Care?

Both long-term nursing care and indefinite residence in a nursing home are not covered by Medicare. With Medicare, you’re qualified for care in a Skilled Nursing Facility (SNF) if your parents have been in the hospital for 3 days and still need care. Medicare Part A would, however, require a deductible, just under $1400, for the first 20 days of your stay. From days 21-100, you’d pay $167.50 per day out of pocket. After that period of time, there is no more coverage for a long-term facility stay and it’s all your personal expense.

Does Medigap Cover Nursing Home Care?

Just as with Medicare, if you buy Medigap (from an agent) your parents are covered by Medigap when you transfer to a nursing home only if they meet the 3-day minimum hospital stay. Only then would Medigap begin to cover your deductible and your coinsurance, if your parent(s) need to stay more than 20 days but less than 100 days ($167.50 per day). Medigap will not cover you beyond 100 days. There is no coverage for indefinite nursing homestays.

Does Medicare Advantage Cover Nursing Home Care?

Medicare Advantage plans are not standardized, but generally speaking, Medicare Advantage partially covers your parent’s stay (often without the mandatory 3-day hospital stay) but you’ll be charged a daily coinsurance. Like Original Medicare (with or without Medigap), long term care in a nursing facility or an indefinite stay beyond 100 days is not covered.

Medicare Coverage: Custodial Care vs Skilled Care

Custodial care requires no medical training. It includes bathing, dressing and moving from seated to standing and to bed. Skilled care requires medical training and can not be done by a family member. However, even skilled care given by a nurse in the home or in a facility is also subject to a copay.

Medicare Advantage Coverage: Custodial Care vs Skilled Care

Starting in 2019, Medicare benefits may include bathing, grooming, dressing, laundry and even light house cleaning. What is and is not included varies greatly based on the state you live in and the plan you buy. Speak with a trusted agent to get the right plan for you by visiting here.

Home Health Care for Seniors: Medicare vs Medicare Advantage (MA)

With Medicare, home care is provided if it’s a medical problem and the individual is “confined,” meaning they cannot leave the home without assistance. Even then Medicare only pays for the doctor-prescribed medical at-home care on a part-time basis.

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