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Medical insurance can be complicated enough – for seniors, it seems the picture is often more confusing. Most seniors don’t work and many are in ill health or have special medical needs. And many seniors rely on government funded assistant living facilities – an estimated 1 million seniors live in around 30,000 assisted living facilities throughout the country.

Most seniors qualify for either Medicare or Medicaid, depending on their income and situation. Medicare is available to those who are at least 65 years old, and have legally lived in the US for at least 5 years before applying. Medigap insurance is supplemental health insurance taken out by some seniors as a way of supplementing their Medicare insurance.

Medicaid is funded by the government and administered by individual states under their department of insurance. Qualification for Medicaid also depends on an individual’s assets, income and type of residence. Medicaid will usually cover most or all of the costs of nursing home admission and the accompanying care that is necessary.

Some seniors, because of a particularly low income or a specific disability, may also qualify for Supplemental Security Income (SSI) a program administered by the Social Security Administration. This program offers several benefits including providing monthly supplemental payments, food stamps and assistance with hospital visits and drug costs.

If you don’t qualify for Medicaid, what is known as long term care insurance can be purchased for long term stays in nursing homes or assisted living facilities. If you are shopping for long term insurance, you should consider what other benefits are covered under the plan, the costs of premiums and whether the policy covers pre-existing conditions.

Seniors may also find themselves using the services of Health Maintenance Organizations (HMOs) HMOs generally accept Medicare payment and offer lower cost deductibles or co-payments. They also put an emphasis on preventative medicine as well as the actual treatment, and many provide eye care, dental services and emergency care when necessary.

By: Elizabeth Newberry

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