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Health Insurance for Seniors 65 and Older

The average retired couple can expect to spend an estimated $315,000 on medical expenses while in retirement.1 Although you may fall off an employer-sponsored plan in retirement, at age 65, you may be eligible to apply for government healthcare programs like Medicare and Medicaid that can help reduce healthcare costs. These plans, however, may still have coverage gaps. Let's dive deeper into the types of health insurance plans for seniors 65 and older and how they work.

4 Min Read

Table of Contents

Key Takeaways

  • Healthcare costs tend to increase with age, and health insurance for seniors can help reduce those costs. Government-backed programs like Medicare and Medicaid, as well as private insurance, offer cost-saving healthcare coverage.
  • Aflac’s supplemental insurance plans (insurance that helps cover medical expenses not usually covered by your primary insurance plan) can help you with unexpected health events.

What is health insurance for seniors?

Health insurance for seniors helps provide coverage for health events to help seniors reduce out-of-pocket healthcare costs. Most seniors become eligible to apply for additional government health programs upon turning 65. Seniors may leverage public options like Medicare and supplement their insurance with private coverage options.

Why seniors 65 and older should get a health insurance plan

Seniors tend to have higher healthcare costs than younger people. Generally, health declines with age, and you may experience cognitive decline, physical discomfort, and an elevated risk for diseases like cancer.2 Treating illnesses can rack up significant hospital bills.

Health insurance is important for seniors because:

  • It can help reduce out-of-pocket healthcare costs.
  • It provides benefits when you visit the doctor, helping to improve early detection of health risks.
  • It helps provide additional peace of mind to your family as your healthcare needs are met.

Types of health insurance plans for seniors over 65

We’ve mentioned a few health insurance options for seniors, but let’s explore a few in greater detail:

Medicare plans

Medicare is the nation's largest health insurance plan, covering more than 66 million people.3 This extensive government program offers health insurance for people aged 65 and older, as well as younger adults with qualifying disabilities or medical conditions like Alzheimer's.

Here are the parts of Medicare:4

  • Part A: Helps cover expenses such as hospital care, nursing facility care, and hospice care
  • Part B: Helps cover medical care, like physician services, durable medical equipment, and outpatient care
  • Part D: Assists with prescription drug costs

Parts A and B include 99% of the nation’s doctors in network,5 but do not cover all of your healthcare costs, which is why some individuals choose to supplement their coverage with Part D.

Medicare Advantage plans

Also known as Medicare Part C, Medicare Advantage is a Medicare plan purchased from a private insurance company. Plans must help cover the same services as original Medicare, but they usually go a step further to include prescription drugs, dental and vision coverage for one monthly premium.5 Your plan may require you to use an in-network doctor or hospital to get the cheapest rates and most coverage.

Medicaid plans

Medicaid is a joint federal and state program that helps income-eligible individuals with medical costs.4 Each state runs its own programs based on general rules set by the federal government, which creates different eligibility requirements and benefits between states. That said, about 12 million people are “dually eligible” in both Medicaid and Medicare and are enrolled in both.6

Medicaid offers benefits not covered by Medicare, like nursing home and personal care expenses. Typically, with Medicaid, you don’t pay for covered medical expenses, but you may have a small co-pay for some services.

Long-term care insurance

Although Medicaid offers some long-term care coverage, it may not be enough for your preferred level of care. Long-term care insurance helps cover the costs of services and support for chronic illnesses or disabilities, including assistance with daily activities like bathing and dressing. Depending on the plan, it may support care:

  • At home
  • In assisted living facilities
  • In nursing facilities

Considering the cost of a private room in a nursing home can cost over $10,000 per month,7 long-term care may be a good supplement to health insurance for seniors.

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How to choose the right health insurance plan for you

After retirement, you’ll likely lose your employer-sponsored healthcare plan. When it’s time to choose your next healthcare plan, consider the following:

  • Age: Unless you have a qualifying disability or chronic illness, you must be 65 to access Medicare benefits.
  • Income and budget: Choose a plan with premiums that align with your financial situation. Medicaid plans are usually the most cost-effective for seniors, but has income eligibility requirements to qualify. If you’re considering Medicare, do a cost-benefit analysis to determine if it's worth paying the premiums to maintain broader coverage and access to more healthcare providers.
  • Health: If you’re chronically ill or have a disability, you may qualify to apply for Medicare early. You may also need specialized care not covered by Medicare, making private long-term care insurance or Medicaid more important.

Aflac offers supplemental insurance for seniors

With supplemental insurance, you can help fill coverage gaps and reduce out-of-pocket costs for unexpected health events. Here are some supplemental insurance plans Aflac offers that seniors can consider:

Get a quote for supplemental insurance

Older adults must think critically about their healthcare needs . Both public and private health insurance plans can support your goals but may leave coverage gaps that expose you to expensive medical bills. Chat with an agent today to discuss Aflac’s supplemental insurance and get a quote.

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Learn more about Aflac products for Individuals & Families: