Why Medicare Matters for Women’s Health
As health insurance that’s available to nearly all U.S. citizens and permanent residents over the age of 65, Medicare is essential to the well-being of people across the country — and to women in particular.
The health policy nonprofit KFF estimated that women made up more than 55% of the 58.7 million people who were on either Original Medicare or a Medicare Advantage plan in 2022. That’s one reason why advocacy groups like the National Organization of Women and the National Women’s Law Center cite Medicare as a vital program for the people they serve.
If you’re currently eligible for Medicare or will be soon, you have important decisions to make about your coverage. Let’s dig deeper into how Medicare makes a difference in women’s lives.
Does Healthcare Cost More for Women?
A Deloitte analysis found that, until they become eligible for Medicare at 65, the average woman has significantly heftier medical bills than a man, even if you don’t count maternity care. Overall, the report showed that U.S. women spend 18% more on annual out-of-pocket expenses. The reasons for this difference include the fact that women tend to see their healthcare providers more frequently and often need to visit specialists in addition to their primary care physicians.
Another key distinction is that U.S. women live almost six years longer than men on average, according to the most recent figures from the Centers for Disease Control and Prevention (CDC), and those later years can involve financial struggles. A 2022 report from the Congressional Research Service noted that older widows, divorced women, and women who have never been married are more likely to fall below the poverty line than either married women or men. This issue worsens as the years pass: Among older people, women over 80 were the group with the highest poverty rate.
So, it makes sense that in a survey conducted by the National Council on Aging, nine in 10 retired women said they were at least somewhat concerned about healthcare costs. To address those worries, it’s critical to make sure that women have access to affordable healthcare as they age.
How Medicare Helps Women
Medicare plays a huge role in managing the healthcare challenges and financial burdens that women face once they’re 65 or older (or sometimes earlier for people who are living with certain disabilities). Original Medicare consists of Medicare Part A, which covers inpatient care such as stays in hospitals and skilled nursing facilities, and Part B, which covers doctor’s visits and durable medical equipment.
Part B also helps with the preventive care that’s essential for healthy aging, helping to avoid potentially life-threatening medical problems and detect warning signs early. Statistics from the Centers for Medicare and Medicaid Services (CMS) reveal that women are more likely to develop multiple chronic conditions like arthritis, osteoporosis, depression, dementia, and high blood pressure.
During an annual wellness visit, Medicare beneficiaries can craft personalized plans to address risks for disease and injury. In addition, Part B covers a range of preventive services that are relevant to women such as:
- Alcohol misuse screenings and counseling
- Bone mass measurement
- Cardiovascular disease screenings
- Cervical and vaginal cancer screenings
- Colorectal cancer screenings
- Depression screenings
- Diabetes screenings and prevention program
- Glaucoma tests
- Hepatitis screenings
- HIV screenings
- Lung cancer screenings
- Mammograms
- Nutrition therapy services
- Obesity screenings and counseling
- Sexually transmitted infection screenings and counseling
- Tobacco use cessation counseling
- Vaccines
If you’re on Original Medicare, you can choose to add a Medicare Part D prescription drug plan from a private insurer. Before enrolling in a plan, be sure to learn about the coverage it provides for all the medications you take and the costs involved.
Some recent updates to the federal rules for prescription drug coverage might make your healthcare more affordable. If you have a Part D plan and take injectable insulin for diabetes (or if you’re on Part B and administer insulin with a pump), you’ll pay no more than $35 for a month’s supply. For Medicare beneficiaries who have limited incomes and resources, the Extra Help program can assist with monthly premiums and coinsurance.
Women and Medicare Advantage
Medicare Advantage plans are offered by private insurers and can give women an array of additional options. These plans substitute for Parts A and B, and they usually include Part D coverage, and often include other supplemental benefits like vision, dental, and hearing care.
Depending on your health and financial situation, you may qualify for a Special Needs Plan (SNP). A SNP is a type of Medicare Advantage plan that offers coordinated care and is tailored for specific groups of people. These populations include people living with certain chronic health conditions, who have low enough incomes to qualify for Medicaid, or who require a stay in a long-term care facility.
To get the most of Medicare Advantage benefits, you’re usually required to see healthcare providers and use pharmacies that are in your plan’s network. However, these plans do allow some flexibility: For example, women can choose to identify their gynecologist as a primary care provider. That may result in savings if you need to see your gynecologist frequently.
Certain Medicare Advantage plans offer benefits to help cover food and over-the-counter items. Women can use this assistance to manage common health issues, like taking calcium supplements that may help to prevent the loss of bone density (which can lead to osteoporosis).
There’s a variety of complex factors that affect healthy aging as a woman. However, you can manage some of the biggest issues that affect your future by carefully considering your health coverage and making the choices that best fit your needs.
About GoHealth
GoHealth is a leading health insurance marketplace and Medicare-focused digital health company. Enrolling in a health insurance plan can be confusing for customers, and the seemingly small differences between plans can lead to significant out-of-pocket costs or lack of access to critical medicines and even providers. GoHealth combines cutting-edge technology, data science, and deep industry expertise to build trusted relationships with consumers and match them with the healthcare policy and carrier that is right for them. Since its inception, GoHealth has enrolled millions of people in Medicare plans and individual and family plans. For more information, visit GoHealth.com.
