As we approach retirement age, a great deal of planning is required to ensure our golden years are as stress-free as possible. For most, a key type of planning that comes to mind is retirement planning, which guarantees you have the financial security to live a comfortable post-retirement life. But Medicare planning is equally important, helping protect your health and providing continued access to quality care as you age.
Medicare is the federal insurance program for Americans 65 and older, comprising multiple parts dedicated to different services. But while Medicare’s goal is to be comprehensive, it doesn’t cover everything, making it all the more vital that you craft an in-depth Medicare plan to ensure your needs are accounted for.
To address Medicare’s pitfalls, some older adults consider additional options to buttress their coverage and enrich their retirement years. One such option is Evergold. Evergold’s Life Plan at Home program serves as a strategic complement to Medicare, bridging gaps in coverage and offering robust support for both health and financial well-being. This innovative program not only aligns seamlessly with Medicare's structure but enhances it, ensuring members receive comprehensive care and financial protection right in the comfort of their own homes. Evergold's approach offers a forward-thinking way to integrate healthcare and financial planning, providing a secure and stable foundation for a fulfilling retirement.
Read on to explore the importance of Medicare planning, the limitations of Medicare, and how Evergold’s Life Plan at Home can be a valuable component of your Medicare plan.
Why Medicare Planning Matters
The closer you are to retirement age, when Medicare takes effect, the more critical this planning is. But even if retirement is quite a ways down the road, it’s still worth considering both the impact Medicare will have on your senior living options and the ways you can prepare for Medicare now. Medicare planning involves making informed decisions about the various parts of Medicare and the ways these parts may or may not impact you. It also includes understanding what is covered by Medicare, what is out of this program’s scope, what this coverage might cost, and how supplemental plans can fill the gaps in care. Without a plan tailored to your needs, you might face unexpected medical expenses that can erode your retirement savings.
But how can you plan for Medicare if you don’t know what kind of support you’ll need in 10, 15, or even 20 years? Simply put: you can’t. This is why anticipating your future healthcare needs is crucial to Medicare planning. As we age, the likelihood of requiring additional medical services increases. At 65, there is roughly a 70% chance we’ll need some kind of long-term care or professional support.1 Considering this statistic, it becomes exceedingly important for older adults to not only understand the current coverage but also to plan for any potential health challenges that may arise. This foresight alone can help make your retirement years far more comfortable and secure.
What Does Medicare Cover?
Medicare consists of several parts, each addressing different aspects of healthcare. Let’s closely examine each of these parts. The below information is courtesy of the Medicare office, and detailed descriptions of each part are available at the Social Security Administration’s Medicare portal.
Part A
This part of Medicare primarily covers hospital stays, skilled nursing facility care, hospice care, and some home health care. It’s worth noting that Medicare Part A does not cover custodial care, i.e. any type of support with daily living activities like dressing or bathing.
Part B
Part B of Medicare focuses on necessary inpatient and outpatient care related to treating, diagnosing, or preventing medical conditions and illnesses. This includes doctor visits, flu shots, vaccines and other preventative services, and some home health care. Keep in mind, however, that while Part A of Medicare is generally free for taxpayers, Part B coverage may come at an additional cost.
Part C
Also known as Medicare Advantage, Part C combines elements of Parts A and B and is offered by private insurance companies under the purview of the Medicare office. To sign up for a Part C plan, you must first enroll in Parts A and B. This can confuse some enrollees and is where Medicare planning becomes particularly vital –– as you may find that your specific needs will be met through a combination of Parts A, B, and D, warranting Part C coverage.
Part D
Part D of Medicare pertains primarily to prescription drug coverage and requires enrollees to purchase different tiers of coverage from private insurance providers.2 Like Part C, individuals are required to enroll in Part A and Part B to receive these benefits.
Medigap
While you might secure traditional gap insurance if you’re between jobs or missed your open enrollment window but still want healthcare, Medicare Supplemental Insurance or Medigap insurance is meant to fill the gaps in care between Parts A and B of Medicare.3 This supplemental insurance helps cover some out-of-pocket medical costs. Yet, it’s just one of the ways you can pay for care not covered by Medicare –– with Evergold’s Life Plan at Home being another valuable asset to your Medicare planning.
What Doesn’t Medicare Cover?
Between the four parts of Medicare, this program provides largely comprehensive coverage to eligible enrollees. However, there are notable gaps that individuals should be aware of during the planning process. Below are some notable absences from Medicare’s coverage.
- Daily In-Home Care: As outlined above, Part A of Medicare covers some aspects of in-home care. It does not, however, cover costs associated with daily living: meal preparation, bathing, cleaning, and general assistance. For many seniors choosing to age in place, this can be one of the most glaring downsides of Medicare, as any savings from in-home care vs. nursing homes or assisted living are lost in out-of-pocket care costs. Evergold covers the expenses that Medicare doesn’t, preventing you from burning through your retirement savings for the sake of comfort, safety, and wellness.
- Most Long-Term Care: Parts A and B of Medicare cover temporary stays in rehabilitation centers, but only for a few weeks or long enough to recover and head back out into the world. Those in need of long-term care, like the kind found at an assisted living facility or nursing home, will have to pay out of pocket to cover these costs. The average monthly cost of a private room in an assisted living facility exceeds $4,500, while a private room in a nursing home can approach $10,000 each month.4 Should you need long-term care, your options for covering these costs will be to rely on your savings or investments, explore Medicaid (depending on your financial situation), or consider other living alternatives, like aging in place with Evergold’s Life Plan at Home.
- Podiatric Care: Medicare does cover podiatry treatments for foot care related to diabetic nerve damage or other more serious injuries, but those in search of general foot care –– like preventative maintenance or callus removal –– will have no other choice but to pay out of pocket. However, if you have diabetes or some other chronic condition, Medicare’s podiatry coverage can be quite generous. In these cases, the program provides access to custom shoe inserts, prosthetics, and even nail-clipping if it’s medically necessary.5
- Routine Eye Exams: While cataract treatments and surgeries are covered by Parts A and B of Medicare, routine eye exams and optical appointments are not. What’s more: Medigap insurance doesn’t cover these expenses, either –– although some Medicare Advantage plans (Plan C) do. Fortunately, this expense isn’t as steep as many other medical costs. Still, older adults living on a fixed income may want to consider a separate policy to retain vision coverage in retirement.
Where Does Evergold Fit Into Your Medicare Planning?
There’s a lot that Medicare does cover, but its many gaps exist in what would be classified as “non-medical” expenses. Evergold’s Life Plan at Home has been designed to bridge the many non-medical gaps in Medicare’s coverage, giving members more options by covering the costs of things like home health aides, memory care, concierge medicine, and other significant expenses absent from Medicare’s scope. Evergold’s Life Plan at Home is a lifelong membership service that works in tandem with your health and long-term care insurance to create a comprehensive plan akin to a portrait of you. We factor in your health (now, tomorrow, and forever), your needs, and your goals to help you live and age better in a comfortable, familiar environment: your cherished home. For this reason, Evergold doesn’t just seamlessly integrate into your Medicare planning –– it can be the foundation on which your Medicare plan is built.
Incorporating Evergold's Life Plan at Home into your Medicare planning is about enhancing your overall quality of life during retirement. With Evergold, you gain a partner who understands the complexities of aging and offers personalized, proactive solutions. From managing daily in-home care to covering expenses not included in Medicare, Evergold ensures that you are prepared for the future, both financially and health-wise. This holistic approach empowers you to enjoy your golden years with peace of mind, knowing that your health, home, and happiness are safeguarded by a comprehensive, thoughtfully tailored plan.
If you’re 55 or older in the Columbus, OH, area, you may be able to kick off the Medicare planning process by joining Evergold. Chat with one of our Membership Counselors today to learn more about Evergold’s Life Plan at Home.
Sources:
1. LongTermCare.gov. How Much Care Will You Need?
2. Investopedia. Medicare Part D: What It is, How It Works, Example.
https://www.investopedia.com/terms/m/medicarepartd.asp
3. Medicare.gov. What’s Medicare Supplemental Insurance (Medigap)?
https://www.medicare.gov/medigap-supplemental-insurance-plans/#/m/?year=2024&lang=en
4. AARP. Does Medicare cover routine foot care?
https://www.aarp.org/health/medicare-qa-tool/does-medicare-cover-foot-care
5. Money.com. Assisted Living vs. Nursing Homes: Care and Cost Differences.
