If you live with chronic illness, it’s essential to make sure you can receive medical care. But if you’re looking into Medicare coverage options, you may feel overwhelmed trying to figure out the best option for you.
Here, we’re discussing the most common chronic conditions in older adults and which Medicare plan you should choose to get as much coverage as possible.
Chronic illness is more common than you might think. According to the National Council on Aging, 80% of adults ages 65+ have at least one chronic condition, and 68% have two or more.1
What chronic illnesses can Medicare help with? Examples of the most common chronic conditions in older adults include:
- Hypertension (high blood pressure)
- High cholesterol
- Ischemic/coronary heart disease
- Chronic kidney disease
- Heart failure
- Alzheimer’s and dementia
- Chronic obstructive pulmonary disease
While treatment for these conditions will vary, it can include a combination of doctor appointments, prescription medications, hospital visits when needed and anything else that helps you stay on top of the condition and its symptoms and complications.
Medicare Coverage Options
Ideally, your Original Medicare plan can help save you time and money while providing the care you need. However, individuals who live with chronic illness can have more health expenses than people who do not. Direct healthcare costs for a patient with chronic disease in the U.S. average $6,032 per year — approximately five times that of a person without chronic disease.2
This means original Medicare might not cover all of your health-based bills (especially if you would like to pursue alternative medical care).
A Medicare Advantage plan may be a good choice for people who need more medical care for chronic conditions. If you choose a Medicare Advantage plan, you may be able to access additional benefits that could help manage or even improve your chronic illness. A Medicare Advantage plan includes everything covered by Medicare Part A (hospital coverage) and Part B (medical coverage), in addition to sometimes covering:
- Prescription drugs coverage
- Dental, vision, or hearing (including allowance for hearing aids)
- In-home care
- Alternative medicine or supplements
- Wellness programs with fitness benefits
A Medicare Advantage plan is provided by private health insurance companies instead of the federal government. It tends to cover more than original Medicare, and this is why it may be beneficial for people with chronic conditions. Medicare Supplement, on the other hand, pays out-of-pocket costs not covered by Original Medicare.
Choosing A Medicare Advantage Plan
Keep in mind that to qualify for Medicare Advantage, you need to already be enrolled in Original Medicare (Part A and Part B). It’s also important to know that you cannot have a Medicare Advantage plan and Medicare Supplement insurance at the same time.
There are a lot of Medicare Advantage plans out there. You might feel overwhelmed trying to choose the best one for you. As you research, consider questions such as:
- Your medical needs and whether your current plan covers them
- The health services you use the most often
- Whether you need help around the house
- If you’re interested in trying alternative medicine
If your Medicare Advantage plan doesn’t cover prescription drug coverage, you can add a Medicare Part D plan. This will cover prescription drugs.
Overall, no matter the specific plan you end up with, a Medicare Advantage plan may also offer access to additional services that can help improve your quality of life, such as coverage for transportation*.
Make sure Medicare Advantage plan is available in your area. Enter your ZIP code to explore plans near you.
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1The Top 10 Most Common Chronic Conditions in Older Adults, https://www.ncoa.org/article/the-top-10-most-common-chronic-conditions-in-older-adults, April 2021.
2 Chronic Disease in the United States: A Worsening Health and Economic Crisis, https://www.americanactionforum.org/research/chronic-disease-in-the-united-states-a-worsening-health-and-economic-crisis/#_edn22, September 2020.
myHealthPolicy.com and K.F. Agency, Inc. are not connected with or endorsed by the United States government or the federal Medicare program.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Not all plans offer all of these benefits. Availability of benefits and plans varies by carrier and location. Deductibles, copays, coinsurance, limitations, and exclusions may apply. Plans are insured or covered by a Medicare Advantage organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare.
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