Medicare, the federal health program that covers more than 50 million Americans over the age of 65 or those who are younger but with permanent disabilities, will have to shift with the changing healthcare landscape in the U.S. Not only that, but Medicare is crucial for retirement security for more than 22 million women who are older than 65 or who have lower incomes and who also have chronic health issues than their male counterparts.
More than half of those who receive Medicare are women. This presents a unique quagmire considering both rising healthcare costs and the uncertainties associated with the Affordable Care Act. It also presents challenges to elder care attorneys who are looking to protect their clients without compromising quality or the level of care they may receive in the future. Needless to say, lawmakers have much to consider as they go about the business of evolving Medicare.
Women and Medicare Dynamics
In its simplest structure, Medicare has four parts that define it.
Part A This part covers inpatient hospital care, skilled nursing facility care after a hospital stay, hospice and home health services.
Part B This portion covers physician services, outpatient hospital care, mental health services, home health, x-rays, diagnostic tests, durable medical equipment, and preventive services.
Part C This is also known as Medicare Advantage and it provides benefits covered under Parts A and B – and sometimes Part D – via private health plans, such as HMOs and PPOs.
Part D This part provides prescription drug coverage through private plans (stand-alone drug plans and Medicare Advantage plans), with additional premium and cost-sharing subsidies for beneficiaries with limited incomes and assets.
Older Women and Their Long Term Needs
The health needs of older women on Medicare have shown to be many and varied. The fact that women typically outlive their male counterparts plays a role and on average, they also have more health care needs. From chronic conditions such as arthritis, hypertension and some cancers to the need for more surgeries, the gap widens the older they get.
A recent study shows that older women also were more apt to have cognitive impairments, including dementia and memory loss. This can affect not only their safety, but their ability to live alone and make daily decisions. Because they outlive men, they’re more likely to be widowed, which can introduce some emotional problems. In fact, 38 percent of women live alone while only 19 percent of men live alone. This suggests women may find themselves a bit more isolated at some point, which can certainly add to problems – physical or emotional – they may already be experiencing.
This increases the odds of their need for long term health resources. And while women may live alone more often than men, they also represent 70 percent of nursing home admissions. This means they find themselves not only alone, but more likely to find themselves sacrificing their independence and perhaps a home they’ve known and loved for years.
Unfortunately, Medicare doesn’t offer a complete coverage for the services in a nursing home. It’s limited both in the scope of time it’s approved and this can mean higher out of pocket expenses, which can effectively place her in poverty.
Finances and Older Women
Women will receive lower average Social Security and pension benefits than men. They earn less and the gap, while improved over the years, still isn’t level. Women still earn approximately 88 cents to every dollar earned by men. Not only that, but many women don’t work as long as men – they may choose to be homemakers or work part time while they raised their families.
Among Medicare beneficiaries ages 65 and older, women have lower median per capita income than men ($21,853 compared to $27,480 in 2012), as well as lower median combined value of financial assets and retirement savings; $65,802 versus $93,371 in 2012.
As elder care attorneys, we see all too often couples who sacrifice throughout their lives only to see their careful estate planning go to out of pocket expenses when various healthcare policies fall short of meeting the needs of those they protect.