As you or your loved ones continue to age and approach retirement, healthcare costs become more concerning. While structuring your long-term financial plan healthcare as you age, consider researching various government programs that provide essential income to those needing assistance.
If you are researching healthcare options for an aging parent or loved one (or intend to have someone help you search for yourself), ensure you are approved to discuss and view his or her medical records prior to addressing their healthcare assistance options. The Health Insurance Portability and Accountability Act (HIPAA) regulates patients’ privacy, and only those who are accredited through the completion of a release authorization form can legally discuss someone else’s healthcare. Even if you prove relation to your parent or caregiver, this form must be completed (with signatures) and filed with all health providers for you to assist your parent or to be assisted.
Below are government programs that can help fund healthcare for those approaching retirement or who are seeking financial assistance as they enter older age.
Medicare, Medi-Cal, and PACE
Upon turning 65, all United States citizens are eligible for Medicare ─ a health insurance program designed to aid in four parts:
- Part A includes hospice care, home health care, nursing facilities, and inpatient hospital visits. A monthly premium isn’t required to receive these benefits, but you will likely have to make co-payments and pay a yearly deductible.
- Part B includes approximately 80 percent of Medicare-approved doctors’ bills, outpatient care, lab tests and X-rays, ambulance services, physical therapy, some prescription drugs, and other preventive healthcare services. You might have to pay a monthly premium based on when you enrolled and your cost of living. The premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check.
- Part C: Medicare Advantage allows you to receive services covered in Parts A and B through a private insurance company.
- Part D includes prescription drug coverage offered through insurance and private companies. A monthly premium, yearly deductible, and co-payments are required.
Medi-Cal, California’s Medicaid program, is a joint federal- and state-funded program that helps cover healthcare costs for those with limited income and resources. It covers some benefits not often covered by Medicare, such as nursing home costs. If your parent is dual eligible for both Medi-Cal and Medicare, most of their healthcare costs will likely be covered.
Programs of All-Inclusive Care for the Elderly (PACE) is a program offered to individuals qualified for Medicare or Medicaid. PACE organizations contract with community specialists to provide services to the home, in the community, and at PACE centers. PACE can provide services that are funded by Medicare and Medicaid, and may also cover care not covered by Medicare and Medicaid such as dentistry, emergency visits, and nutritional counseling.
Social Security Income
If an individual worked or is married to someone who worked for wages (or was self-employed and paid taxes) for at least 10 years (full or part time), or if he or she became disabled prior to retirement age, they are likely eligible for Social Security benefits. Additionally, if an individual is a surviving spouse of someone who was eligible for Social Security benefits, they are likely eligible as early as age 60.
The Social Security benefit amount depends on the individual’s earned wages during their time in the workforce — higher earnings yield higher benefits, and inconsistent employment patterns or early retirement may result in lower benefits. The average monthly Social Security benefits paid in 2017 is $1,360 for a single retired worker, and adjusts yearly based on inflation and cost of living. To estimate eligibility, use the Online Retirement Estimator provided by the Social Security Administration.
Keep in mind that if you or your parent(s) qualify for more than one Social Security benefit, the higher of the two benefits options will be rewarded, and two payments may not be claimed, even at different times.
Department of Veterans Affairs (VA)
The VA provides a tax-free monthly pension to uniformed service members and veterans (dependents and surviving spouses or children may also qualify) who are permanently disabled or are 65 years of age or older. The Aid and Attendance (A&A) improved pension are increased benefits for veterans or surviving spouses who require at-home, nursing home, or assisted living care. Additionally, military veterans who suffer a service-related disability may be entitled to an extra tax-free benefit to help pay for medical care and prescriptions. Contact your regional benefit office to learn more about how the Department of Veterans Affairs can help fund healthcare.
Local Elder Assistance Programs
Below are region-specific and local programs that can help guide you or your aging parent to a fitting assistance program.
Area Agencies on Aging (AAAs)
AAAs are federally mandated and are staffed with knowledgeable professionals in the elder care field. There are several AAAs that cover Canopy Health’s coverage area. Find the area agency closest to you to explore the cost of available services in your area, including mobility assistance programs, meal plans, housing, counseling, respite care, and support groups. AAAs staff can also determine which programs or benefits you or your loved one may qualify and help gather data and documentations necessary for application.
State and Local Governmental Representatives
Most U.S. Senators and Congressional Representatives have a staff specialist on elder affairs. Contact a California senator or house representative to receive information regarding programs, services, and benefits that could assist you or your parent. Advisement and advocacy are a critical part of our legislators’ roles as government leaders.
Canopy Health Is Here to Help
Healthcare can be confusing, but Canopy Health is doing our part to make things more clear by providing high-quality care through customizable healthcare plans, personalized service and assistance, and our network of reputable alliance partners. Our network consists of more than 4,000 physicians and dozens of hospitals and care centers located across seven Bay Area counties.
To learn more about our alliance members, carrier partners, and physicians, contact us at 888-8-CANOPY or complete this brief online form.
Sollito, M. (n.d.) 10 Government Programs You Can Access for Your Elderly Parents. Aging Care. Retrieved from https://www.agingcare.com/articles/10-government-programs-caregivers-can-access-for-their-elderly-parents-120513.htm
Sollito, M. (n.d.) The 4 Parts of Medicare. Aging Care. Retrieved from https://www.agingcare.com/Articles/What-are-the-Different-Parts-to-Medicare-133611.htm