New York Estate Planning & Elder Law Blog
President Biden as well as progressive Democrats have proposed lowering Medicare’s eligibility age to 60 to help older individuals obtain affordable coverage. A new study, however, has found that Medicare is more expensive than other options for individuals with modest assets. Two reasons exist why Medicare is more expensive: traditional Medicare contains gaps in what it covers which often necessitates purchasing supplemental insurance. Additionally, premiums for the Affordable Care Act have dropped substantially due to President Biden’s COVID relief measure and as a result, the act has become more attractive. This article reviews some critical details that you should remember if you’re helping a loved one consider whether Medicare is the best option for them.
# 1 – Long Term Care Insurance
Provided that you’re capable of being insured and can pay for the premiums, long-term care might be the best option that you need to satisfy your needs. Coverage, however, varies based on the insurance company you utilize as well as what plan you end up choosing. Assisted living costs continue to climb, though. If you can pursue long-term care insurance as an option, you should make sure to start planning early. The more a person ages, the more difficult a time an individual has getting covered by an insurance carrier.
# 2 – Employer Coverage
Part A of Medicare is premium-free for most people, but a person can decide to delay enrollment in Part B of Medicare if that individual had employer coverage. You have the option of choosing between your employer’s group health plan if you’re still working at the time you become Medicare-eligible. Medicare works in combination with employer health insurance based on your employer’s company’s size. Before deciding to pursue employer coverage instead of Part B of Medicare, make sure to compare the prices between the two. If Medicare is more affordable than your employer coverage, it likely makes sense to pursue Medicare instead.
# 3 – Marketplace Coverage
It’s possible to retain insurance purchased through the ACA marketplace after you become eligible for Medicare. By deciding to pursue coverage through the marketplace, however, you will lose your premium subsidy after you become eligible for premium-free part A. Consequently, you’ll be required to pay the full price for your healthcare plan. In these situations, Medicare is almost always the more affordable option.
# 4 – Medicare Advantage
Medicare Advantage unfortunately does not exactly function as a good substitute for Medicare. Even though it’s sometimes referred to as a “replacement plan”, an advantage plan requires you to enroll in Part B. Additionally, Part C must cover any service that either Part A or Part B covers. Pursuing Medicare Advantage, however, can sometimes prove advantageous. For example, individuals with disabilities often find the plan an attractive option. Medicare Advantage can also be ideal if a person cannot afford monthly costs for Medigap.
Contact a Compassionate Elder Law Attorney
The Medicare process is just one of many nuanced areas involved with elder law. Contact an experienced attorney at Ettinger Law Firm today to schedule a free case evaluation.