By the year 2030, there will be roughly 79 million people enrolled in Medicare. That number showcases the popularity of the program, particularly amongst low-income seniors.
If you’re approaching the age of 65 and are wondering whether or not Medicare is something you should be looking into, you’ve come to the right place. In this post, We’re going to go over several Medicare facts you may not be aware of.
By arming yourself with information on this mode of healthcare coverage, you should be able to come to a sound determination on whether or not enrolling in Medicare will best serve your health needs. Keep reading to start learning!
1. Medicare Is Run by the Government
Those that prefer the government stay out of their healthcare need not apply for Medicare. The program is funded by the federal government and as such, you’ll need to answer to them when making claims on various medical services you receive.
The good news is that while the government issues your insurance, they (in most cases) don’t fully employ the doctor that’s issuing your treatment. That affords you some separation between elected/non-elected officials and your healthcare privacy.
2. The Program Is Mostly Targeted at Seniors
Healthcare coverage that’s furnished through Medicare was established primarily to aid seniors that could no longer work in attaining affordable medical services. That’s why, to enroll in Medicare, you have to be 65 years old. Therefore, unfortunately, if you are under this age, you would have to look elsewhere for health insurance.
There are exceptions to the 65 year enrollment age, of course. For example, if you have a covered medical disability, you may be able to claim Medicare coverage in advance of your 65th birthday.
You can learn more about disabilities and Medicare eligibility online.
It is unknown whether Medicare would consider lowering this at all. Many are already calling for the health insurance program to lower it to 60. As all businesses do, they have selected a niche target audience: those over 65, and it has worked for them until now. As more people are living longer, more people in the US are eligible than there would have been half a century ago. However, despite more people living longer, meaning more customers for them, the problem is that many under the age of 65 are experiencing health problems due to not having health insurance in place. Lowering the age would give seniors more flexibility in choosing a health program that works for them and when they can retire. Funding may be necessary to give the company a nudge in doing this. As businesses adapt and change over time to widen their target audience, there is always the potential for Medicare to do the same. This may not happen for some time or ever, of course.
3. High-Earning Individuals Pay More
Medicare is not a flat-rate health coverage plan. Depending on how much income you make, you’ll pay more for the same quality of coverage that a poorer person would.
The brackets that disclose how much individuals will make are updated regularly on the Medicare website so head over there to get the latest Medicare facts regarding what your cost obligations might look like.
4. You’ll Need to Pay Some Money Out of Pocket
The misconception that Medicare covers all medical costs is a widespread one. Medicare covers only 80% of qualifying medical expenses.
That means that if you needed an emergency surgery that carried a price tag of $30,000, you’d still need to pay $6,000 out of pocket. While it’s obviously helpful to be relieved of 80% of your medical costs, paying even 20% can be an impossibility for some low and even medium-income individuals.
With the company only offering insurance to those over 65, this also brings up a massive problem. Many are already retired, and, therefore, this 20% could be a massive drain on their finances. When they don’t have the income to supplement this 20%, people may have to decide between health and finances. No one should have to be forced into making this decision.
This is why Medicare supplement plans have become popular. Many of them plug that 20% hole so you can live with confidence knowing that your medical expenses are covered fully. You can look into this to discover how it could help you, especially if the expense is a lot more than you can afford and would make a direct impact on your quality of life.
5. Long-Term Care Is Not Included
One of the most expensive aspects of getting old is acquiring long-term care. Long-term care is the kind of regular nursing assistance an elderly person might need to manage medications, prepare meals, and the like.
One of the more unfortunate facts about Medicare we have to share is that the program will do nothing to cover costs associated with those sorts of services. That’s a huge problem for families since long-term care can cost as much as $8000 per month in some areas. The alternative of many having to stay in their home or move in with family is not ideal for a lot of people, due to lack of space and time in being able to care for them. However, while Medicare can’t help with this, in some states, there are programs that help offset costs associated with long-term care. These programs exist outside of Medicare. Talk to local senior/disabilities advocates to learn more. You may find that the best solution financially is to bring in an at-home carer. Make sure to speak to your family about the options available and get as much information about the available programs as possible to make a decision.
6. You Won’t Be Covered While Traveling
If you’re one of those older folks that love hopping on planes and seeing new parts of the world, good on you! The bad news is that when you’re abroad, you won’t be able to bill emergency healthcare expenses to your Medicare plan.
While that might sound like an issue, it is avoidable by picking up a short-term supplement plan. Short-term supplement plans for travel or “travel insurance” is low-cost and will make sure that when you’re abroad, your health is protected. As many will be retired and looking to enjoy life a little bit more now, this is great news. You can jet off to somewhere with hot weather where you can relax fully in peace of mind that you are covered if the worst should happen during your travels.
7. Money for Medicare Is Dwindling
Medicare costs hundreds of billions of dollars to keep afloat every year. The way the program is funded is by pulling a little bit out of every working adult’s paycheck each year.
Problematically, new entrants into the workforce are dwindling due to dropping birth rates. On the other side of the spectrum, seniors are retiring in staggering volumes. This is for all industries and businesses, including that of healthcare. This could continue to decline. Of course, there is always hope that it will go the opposite way, too.
That mismatch is creating conditions where the Medicare fund is losing money every year. It’s predicted that by the year 2026, Medicare will either go broke or more likely, will charge recipients much more to enjoy its coverage benefits.
It is not currently known what would happen if this situation played out, but no doubt, another program similar to Medicare would be introduced.
8. Annual Checkups Are Free
Ending our list of Medicare facts on a positive note, we’re glad to tell you that Medicare does allow users to get an annual preventive checkup for free. These checkups help screen you for serious illnesses, dietary issues, and anything else you may want to discuss with your physician. With many illnesses and health conditions, the sooner you catch them, the sooner you can treat them. Therefore, taking advantage of this service could be vital for the good of your health.
Armed with the information you receive during your checkup, you should be able to move through the year confidently and in good health. If your appointment uncovers a potential problem or condition, you can quickly move on to treatment plans and solutions as you have insurance in place. Without this free appointment, it could have gone unnoticed for a long period of time.
The Future of Medicare and Similar Programs
You may be wondering what the future of Medicare or similar programs might look like and whether it is worth looking into. It could be possible that unless the company makes some changes to its policy, it could be at risk of going bankrupt. However, part of the future of Medicare and other similar programs does depend on the healthcare system itself.
For example, fact 8 pointed out that annual checkups are free. This could be a huge benefit to many people looking into getting this insurance, as it could ensure they are keeping on top of any health conditions. However, with clinics and hospitals being swarmed, although the appointments may be free, people may actually struggle to book one. If this benefit was something that influenced their decision to choose this health insurance program and they can’t take advantage of it, why would they continue with it?
When something affects the healthcare system, it may have a knock-on effect on Medicare. If Medicare wants to continue offering health insurance to their customers, then they need to hope that more people join the healthcare profession. From nurses to doctors and administrators, more people are needed in all settings.
More clinics would also need to be opened to cope with the number of people seeking out annual health checkups. These clinics need to be run by qualified professionals with the right skills and knowledge. A Family Nurse Practitioner (FNP), for example, fits this bill, as do doctors.
The problem again lies in the fact that not enough healthcare staff exist who are qualified enough, though. Therefore, it is essential that online programs become more utilized in the coming years. Online programs enable working healthcare professionals to continue working in their current job but build up their experience and knowledge required to take on the position needed to run a clinic. Private clinics should look at enquiring about these for their staff members and approach those who would be interested in developing their careers. Bigger settings such as hospitals should also encourage more of their staff to enhance their knowledge.
Of course, a nurse can always set their own plans in motion for building up their skills and knowledge by taking a 100% online FNP course. They just need to know that they exist in the first place. As nursing is just as much about practical learning as it is theory, not everyone is aware that online learning is possible for this type of profession. However, it is. Insurance programs should be doing what they can to spread the word about these online programs that exist if they want to keep afloat and keep their customers happy.
The other major thing that could change for Medicare moving forward could be the age bracket for which they accept customers. As many are keen to bring about this change within the government, it could be something on the horizon for this health insurance program. If they don’t take advantage of this, another certainly might.
We Hope Our Medicare Facts Brought You Clarity
Health insurance in the United States can be a confusing topic. With private insurers in the marketplace competing against public ones, which option is best for you?
We hope that the medicare facts we’ve shared have equipped you to better answer that question. After all, few things are as impactful to your long-term health as making informed decisions when it comes to how best to pay for your care.
If you’d like additional guidance on health topics, we’ve got you covered. Check out the newest information on our blog to discover more!