Medicare Coverage When You are Over 65

Sunday, October 25, 2009


Medicare coverage is for adults in the United States 65 and older or younger adults that have been collecting social security disability benefits for a period of 24 months.
Photo by: Monique Discawicz

Medicare is free to those that qualify, but what many people don't know until they are covered under Medicare is that it is a very basic insurance that does not cover medications. As we age, we become more and more dependent on medications. Does it make sense that Medicare doesn't cover medications?


How does a person over 65 get their medications paid for by insurance?

It depends on the Medicare rider that is purchased by the insured. Medicare might be free, but it is such a basic insurance that few people have Medicare insurance only. Rider policies can range anywhere from $100 a month to $600 and beyond for a single person.

How does a senior on a fixed income afford a rider plan to cover the cost of medications?

A senior citizen on a fixed income will have to pay for a cheap (100$) a month rider to get any prescription medication coverage at all. Some plans offer $800 worth of medication a year, so if a Medicare recipient pays for their medications anyway, $800 a year of medication will cover eight months of a cheap Medicare rider.

There are programs available for those on a fixed income such as prescription advantage, that will offer medications at a reduced or free rate, but just try as a senior citizen to figure out how to qualify for such programs.

From personal experience, I give you the example of my grandmother, who earned about $900 a month from Social Security.

She paid $105 a month for Blue Care 65. This covered $800 a year in medications. She was on six medications and this $800 ran out every February.

It took my sister and I months to apply for prescription advantage programs and you have to reapply every six months. She continued to pay anywhere from $100-$250 every month for prescription medications.

So her monthly budget was 900-105=795. Subtract the minimum 100 for medications. $695. This is before food, rent, phone or cable. Thankfully she was on a subsidized rent program and only paid $300 a month. This left her with $395 a month for food, phone, cable and entertainment.

My grandmother worked her entire adult life. She pinched pennies everywhere she could. She never relied on any government assistance until the subsidized rental which didn't start until she was 85 years old. From 65-85 she paid for all her bills out of her social security, including her medical costs.

I believe that my grandmother was not out of the ordinary. She did not take an excessive amount of medications during her "senior" years. She worked hard in her lifetime and saved all she could. It was ridiculous that money was so tight because she had to pay for her medications and a Medicare rider plan. 20-30% of her income went every month for health related costs, and she was a healthy senior.

What are we doing?

0 comments:

Post a Comment

 
Blog Makeover by LadyJava Creations