The Pennsylvania Insurance Department has approved several health insurance plans for seniors.
Pennsylvania has the second highest senior population in the United States, according to Seniorjournal.com, making senior health insurance a priority in the state. According to the Employee Benefit Research Institute, 96.1 percent of those 65 and over have Medicare, and plans are available in Pennsylvania to help cover Medicare's out-of-pocket costs. Early retirees may have access to coverage through a former employer or spouse, and may purchase an individual plan. The impoverished can apply for Medicaid, which is low cost to those who qualify.
Medicare
Seniors in the United States (in this case, those age 65 and older) qualify for Medicare by having completed 10 years of work over their lifetimes paying into Social Security. Those who haven't worked 10 years paying into Social Security can purchase Medicare coverage. Part A of Medicare covers any potential hospitalizations, hospice and skilled nursing care. Part B covers other medical needs, including doctor visits, lab tests and durable medical equipment. Part D of Medicare provides prescription coverage but, unlike Parts A and B, is only available through private companies approved by Medicare. Part A usually has no premium, but does have a hospitalization deductible of $1,000. Part B has a monthly premium, a calendar year deductible and coinsurance costs. Part D has a monthly premium and co-pays for prescriptions.
Medicare Supplemental Plans
Medicare supplement plans help to cover the out-of-pocket costs associated with Medicare. Medigap plans are also known as Medicare Supplements. Medigaps are secondary to Medicare and you purchase them through private companies. The plans are standardized by the Federal government, and the companies that sell the plans in Pennsylvania are approved by the state insurance department. Medicare Advantage plans are another type of supplemental plan. These plans typically include prescription coverage and take the place of Medicare Parts A and B (in fact, Medicare Advantage plans are also called Part C of Medicare). They are less expensive than Medigap plans but have higher potential out-of-pocket costs.
Medicaid and Other Help
Pennsylvania seniors with limited incomes and assets may qualify for Medicaid. Medicaid is jointly funded by the state and federal governments and provides comprehensive medical coverage with no premium and Part D prescription coverage. You can find out whether you qualify at your local Medicaid office or by calling the Pennsylvania Department of Public Welfare at (800) 692-7462. Social Security offers Extra Help for Part D prescription plans to many seniors; apply by calling Social Security or visiting your local Social Security office.
Early Retiree Health Insurance
The Patient Protection and Affordable Care Act of 2003 includes provisions for making health insurance more affordable for early retirees. Before the Affordable Care Act, some early retirees either continued plans from their previous employer or received coverage through a spouse, but others either had to buy expensive individual plans or go without health insurance. The Affordable Care Act introduced Early Retiree Reinsurance Program, which pays employers and unions to keep early retirees on their insurance plans. Pennsylvania has numerous companies that are participating, including the H. J. Heintz company, Iron Workers Welfare Plan of Western Pennsylvania and the Pennsylvania Turnpike Commission.
