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What Every Senior Needs to Know About Their Health Insurance

Medicare is a federal program that currently provides health care coverage to fifty-six million Americans aged 65 and above. The program provides a valuable bridge for those exiting employment to be able to afford healthcare-related costs that may arise after they lose their employee medical benefits. One challenge people face with the program, however, is not fully understanding both its benefits and shortcomings.

Because of this, people may end up either missing out on some benefits or getting caught unawares when the program falls short of their expectations. Some programs like that offered by BGA Insurance, provide what is known as Medigap plans to fill in the gaps left by Medicare. However, you will still need to better understand your senior health insurance plan, which the following five points will help you do.

Age 65

One major misunderstanding people have about Medicare is the assumption that they will get automatically enrolled in the program when they turn 65. This is not entirely true. The only time you will get automatically enrolled is if you had already enrolled for Social Security prior to reaching the age of 65. If not, then you must sign up for Medicare separately.

If you do not sign up by 65, you could end up having to pay more for your medical benefits. For instance, Part B payments go up by 10% every 12 months that you have not enrolled after crossing the 65-year mark.


While there are some instances where your Medicare benefits will cover 100% of your medical and hospitalization costs, there are limits. These limits apply to the amount of time you have been hospitalized, how many of your lifetime reserve days you have used up, among other factors.

Understanding the limits of your Medicare cover will help you better plan your healthcare by avoiding unnecessary hospitalization or extended stays at the hospital. Keeping limits in mind can help you stretch your cover while keeping your copay low.

Preventive Services

Medicare contains a list of preventive services that are free. This is information most seniors do not know and so shy away from taking screenings, wellness reviews, flu shots among other wellness services.

In many cases, getting screened can save you money in the long run if health issues are caught early and treated. Cancer and cardiovascular disease screening are also offered free, so this can also help preempt any costly conditions if caught and treated early.

Fine Print

As with any contract, there is fine print in your medical scheme. What that fine print says and what it means to you depends on factors like your type of scheme, level of premiums and copays, among others.

Neglecting to read through this fine print may leave you with some steep medical bills to pay if a treatment or medication is not covered. For example, while it is not automatic that name-brand drugs will cost more than generic drugs or vice versa, it is possible to get either at a lower rate depending on the plan you have.


If you are unhappy with your current plan, Medicare offers a window every year where you can change your plan. This can come in handy if you feel your rates are too high for the treatments you receive or if you feel that a different plan could better serve your current medical needs.

To change over, all you need to do is wait for the annual enrollment period that falls between October 15 and December 7 and switch. However, keep in mind that whatever you pick will have to remain so until the next open enrollment rolls in.