Health Insurance for Seniors

by | Oct 12, 2023

As you approach retirement age, it is important to think about your health insurance options. Medicare, the federal health insurance program for people over 65, is the most common health insurance option for seniors. However, it is important to understand that Medicare does not cover all of your medical expenses, and you may need additional coverage to help fill the gaps.

What is Medicare?

Medicare is a federal health insurance program for people over 65, as well as for people with certain disabilities. It is comprised of four parts:

  • Part A: Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
  • Part B: Covers medical services, such as doctor visits, laboratory tests, and durable medical equipment.
  • Part C: Also known as Medicare Advantage, Part C is a private health insurance plan that provides all of the benefits of Parts A and B, as well as additional coverage for prescription drugs and other benefits. (Not all Medicare beneficiaries have Part C.)
  • Part D: Covers prescription drugs.

What Does Medicare Cover?

Medicare covers a wide range of medical services, but it is important to understand that it does not cover all medical expenses. Some of the medical expenses that are not covered by Medicare include:

• Long-term care: Medicare does not cover long-term care services, such as in-home care or assisted living.
• Most dental services: Medicare does not cover routine dental services, such as cleanings, fillings, or extractions.
• Eye exams for glasses or contacts: Medicare does not cover routine eye exams for the purpose of obtaining glasses or contacts.
• Hearing aids: Medicare does not cover the cost of hearing aids.

Do Seniors Need Additional Coverage?

While Medicare provides comprehensive coverage for a wide range of medical services, it is important to understand that it does not cover all of your medical expenses. For this reason, many seniors choose to purchase additional coverage to help fill the gaps in their Medicare coverage.

One popular option for additional coverage is a Medicare Supplement (Medigap) plan. Medigap plans are private health insurance plans that are designed to help cover the out-of-pocket costs associated with Medicare, such as deductibles, coinsurance, and copayments.

Another option, Medicare Advantage, also known as Medicare Part C, is an alternative to traditional Medicare offered by private insurance companies. These plans provide comprehensive coverage that combines hospital insurance (Medicare Part A), medical insurance (Medicare Part B), and often prescription drug coverage (Part D) in a single plan. Additionally, many Medicare Advantage plans offer additional benefits, such as dental, vision, and wellness programs, making them an attractive option for those seeking comprehensive healthcare coverage.

How Do You Decide What Senior Health Insurance is Right For You?

Think about the type of medical services you typically use and whether you will need additional coverage for long-term care or other services that are not covered by Medicare. You also need to consider:

• Your budget: Consider the cost of your monthly premiums, as well as any deductibles or copayments you may have to pay out of pocket.
• Your preferred health care providers: If you have a preferred doctor or hospital, make sure that they are included in the network of providers for your health insurance plan.

Once you have taken these factors into consideration, you can begin to compare the different health insurance options available to you as a senior. This may include comparing the cost and benefits of different Medicare Supplement plans, as well as the benefits and cost of Medicare Advantage plans.

There are Medicare insurance brokers, like Acuity Health Advisors, that can help you narrow down your options and decide which plans are right for you. Most Medicare brokers offer their services at no cost to you.

Additionally, it is important to understand that health insurance options can change each year, so it is a good idea to review your options and make any necessary changes each year during annual enrollment.

What Health Insurance Options are Available for Seniors Who Don’t Yet Qualify for Medicare?

Seniors who are not yet eligible for Medicare have several health insurance options to consider. Eligibility for Medicare typically begins at age 65, so if you’re retiring before that age or need health insurance for other reasons, here are some alternatives:

1. Employer-Sponsored Health Insurance: If you’re still working or your spouse is, you may have access to employer-sponsored health insurance. This can be an excellent option, as it often provides comprehensive coverage.

2. COBRA: If you retire or lose your job before you’re eligible for Medicare, you may be able to continue your employer-sponsored health insurance for a limited time under the Consolidated Omnibus Budget Reconciliation Act (COBRA). Keep in mind that you’ll typically have to pay the full premium cost.

3. Health Insurance Marketplace Plans: You can explore health insurance options through the Health Insurance Marketplace, where you can purchase individual or family plans. Depending on your income and state of residence, you may qualify for subsidies that can make coverage more affordable.

4. Medicaid: If your income is low, you may be eligible for Medicaid. Medicaid provides free or low-cost health coverage to individuals and families with limited income and resources. Eligibility and benefits vary by state.

5. Medicaid Expansion: Some states have expanded their Medicaid programs to cover more low-income adults, even if they don’t have dependent children. Check if your state has expanded Medicaid eligibility.

6. Private Health Insurance Plans: You can purchase private health insurance plans directly from insurance companies. These plans vary widely in terms of coverage, cost, and network of providers.

7. Short-Term Health Insurance: Short-term health insurance plans are designed to provide temporary coverage for specific needs. These plans are generally more affordable but offer less comprehensive coverage and may not cover pre-existing conditions.

8. Veterans Health Care: If you’re a veteran, you may be eligible for health care through the Department of Veterans Affairs (VA). The VA offers various healthcare programs and services.


As a senior, it is important to understand your health insurance options and choose the right coverage for your individual needs and budget. Whether you choose to enroll in Medicare or you need to consider non-Medicare options, make sure you understand the benefits and costs of your coverage and take the time to review your options each year. At Acuity Health Advisors, we pride ourselves on giving our clients the information they need to make informed decisions. We offer no-obligation free consultations year-round to help you with your health insurance needs. We can help you find the right health insurance coverage so you can be confident that you will have the financial support you need to manage your health care expenses in retirement.


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