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Health Insurance Options at Age 65

There are many health insurance options for those over 65. These include types of private insurance, Medicare, coordination of private plans and Medicare, Medicare gap policies, and Medicare advantage plans or what are sometimes called senior care HMO plans.

  1. Private Insurance Options

    • Some seniors or those over 65 have insurance that carries over into retirement. There are three basic types of private health insurance -- a traditional plan where you are allowed to go to any doctor; a health maintenance organization plan in which you go to a doctor contracted within the plan; and a preferred provider network plan that allows the patient to see a doctor either in network or out. Benefits for in network are usually covered better than for out of network.

    Medicare

    • Medicare now has four parts. Part A is automatic, and covers hospital care. Part A is given at no charge to the patient. Part B covers doctor visits, therapies and out patient care. There now is a part C, which costs a bit more than part B, but provides coverage for hospital care and doctor care. It covers at a higher rate, and includes prescription coverage. Part D simply adds a prescription drug rider to the Medicare policy.

    Coordination of Benefits

    • If a person over 65 has a traditional insurance plan, it will sometimes coordinate with Medicare. This means that the private plan will pick up anything not covered by Medicare, such as the hospital deductible or office co-pays. It will also cover the 20 percent of part B benefits not picked up by Medicare.

    Gap Insurance

    • Some private insurance companies sell what is called a gap policy. It covers what a Medicare plan does not. However, benefits may not be as high as with coordination of benefits. There still might be some money owed after Medicare and gap insurance. Gap insurance can also be rather expensive.

    Medicare Advantage Plans

    • There is another option for those over 65 -- Medicare advantage plans. Some companies call them senior care plans. These plans are usually HMO plans and paid for from the money for Part B Medicare. The Part B premium goes directly to the private insurance company chosen. The individual insured would then use his or her private Medicare advantage plan instead of the Medicare plan.

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