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Understanding Health Insurance for Elders

As part of our role as Geriatric Care Managers, navigating the complex financial aspects of elder healthcare is at the forefront of the work we do for each of our clients. Aging can be a complex and challenging process, with additional healthcare needs playing a major part in adjusting as we get older. These additional healthcare needs (and their cost!) can be a challenge for elders and families who may be living on a fixed or low income. There are several options to help finance healthcare and its costs, including government programs, retirement plans, and private insurance. In this article, we will overview some of these options and that they can do to help shoulder the financial burden for you you or your elder loved ones’ health.


Medicare is a federal health insurance program that provides coverage to individuals who are 65 years or older, as well as to younger people with certain disabilities. The program is divided into four parts: Part A, Part B, Part C, and Part D.

  • Part A: Hospital Insurance. Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care services.

  • Part B: Medical Insurance. Covers doctor visits, outpatient care, and some preventive services.

  • Part C: Medicare Advantage. An alternative to traditional Medicare that is offered by private insurance companies. These plans often include additional benefits, such as dental, vision, and hearing care.

  • Part D: Prescription Drug Coverage.

While Part A is generally free for those who have paid into the Medicare system through taxes, there are premiums and deductibles for the other parts of Medicare. It's important to understand these costs, as well as the benefits and limitations of each part, when choosing a Medicare plan.

Other Options

Private Health Insurance Plans: Private health insurance plans, such as those offered by employers, can provide coverage beyond what Medicare offers. These plans may be on the more expensive side, but may be worth it if additional benefits are needed.

Medicaid: Medicaid is a joint federal and state program that provides healthcare coverage to individuals and families with low incomes. It can be a valuable option for elders and their families who have limited financial resources.

Medicare Supplements: Medicare Supplements, also known as “Medigap plans”, are private insurance plans that can be used to cover the out-of-pocket costs associated with Medicare. These plans can help elders manage healthcare expenses more effectively.

Long-Term Care Insurance: Long-term care insurance is a type of insurance that provides coverage for long-term care services, such as nursing home care, in-home care, and assisted living. It can be a valuable option for elders who may need these types of services in the future.

Choosing the Best Option

Choosing the right health insurance plan can be a complex process, but it's an important decision that can have a significant impact on healthcare and financial wellbeing. When choosing a plan for yourself or an elder loved one, consider the following factors:

Healthcare needs: Think about the types of healthcare services needed now, as well as services or benefits that may be needed in the future (a long-term health issue, for example).

Budget: Consider the monthly premiums, deductibles, and out-of-pocket costs, and choose a plan that fits your budget.

Provider networks: Check to see if preferred doctors and hospitals are in the plan's network.

Prescription drug coverage: If prescription medications are part of the healthcare needs for you or your elder loved one, ensure the plan you choose covers them.

Understanding Medicare and other health insurance options for elders is an important part of managing healthcare needs that come along with aging. Consider healthcare needs, budget, and provider networks when choosing a plan. If the process is overwhelming or challenging, or you have other life duties that limit the time available to navigate the healthcare industry, consider hiring a Geriatric Care Manager!

If you are interested in discussing any matters of aging with a professional on our team, we offer FREE consultation calls every day at 617-405-8796. You can also leave a comment with your question, send us a direct Facebook or Instagram message, or e-mail us at

Senior Steps provides assistance with medical, legal, and financial advocacy and planning, and help with activities of daily living.

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