Why Women Should Look at Medicare Differently from Men


On average, women live six to eight years longer than men, according to the World Health Organization (WHO). Experts believe various reasons play a role in why women tend to outlive their male counterparts, including biological, social, and behavioral factors. A behavioral example is that women tend to consult doctors more often than men.

While women usually have a longer life expectancy than men, there are several common conditions women tend to develop more than men. Most of these conditions, however, develop later in life around the time women enroll in Medicare. It’s important for women to know how Medicare covers screenings, diagnostic tests, and treatment for these conditions.

Female-predominant medical conditions

There are a few common chronic medical conditions that affect women more than men, generally. These include breast cancer, osteoporosis, and arthritis. The risk factor for developing these conditions rises with age, too.

For example, according to the Centers for Disease Control and Prevention (CDC), most breast cancer cases aren’t diagnosed until after age 50. The same is true for osteoporosis. The bone-related disease affects women over 50 more than any other age group. Also, according to Harvard Medical School, over 75% of Americans with osteoporosis are female. Women 50 and older have a 33% chance of fracturing a bone due to osteoporosis.

Arthritis, although common among both genders, affects only 18% of all men, according to CDC estimates, whereas 24% of all women will develop it. These conditions are only a few reasons why women should look at Medicare differently from men. Medicare plan options

Medicare plan options

Original Medicare (Part A and Part B) is the default option for Medicare enrollment. There are separate premiums, deductibles, and cost-sharing for each part of Medicare, and there is no annual cap on out-of-pocket spending. However, Original Medicare offers maximum flexibility to see any provider in the country who accepts Medicare.

Medicare Advantage plans

Medicare Advantage is private health insurance that replaces Original Medicare. You may or may not have a monthly premium, and many plans offer $0 deductible options. Cost sharing is also determined by the insurer.

You may need to use a provider network with Medicare Advantage and there may be other restrictions with your coverage. However, all Medicare Advantage plans have a maximum out-of-pocket limit each year. The limit is set by Medicare; it is $6,700 in 2020, although many plans set their limit below the government-allowed maximum. Most plans also include Part D prescription drug coverage.

Medicare Supplement plans

Medicare Supplement plans help cover Part A and Part B cost-sharing expenses, such as deductibles, copays, and coinsurance. Each Medicare Supplement plan covers a different combination of these expenses. For example, Plan G covers all Part A and Part B cost-sharing expenses except the Part B deductible.

Medicare Supplement plans are generally attractive to people with costly health conditions and healthy people who want to be prepared if they are diagnosed with an expensive medical condition.

Medicare Advantage plans tend to have lower premiums than Medicare Supplement plans. Some even have $0 premiums. Medicare Advantage plans are attractive to people who would rather have a lower premium and pay cost-sharing as they use the plan rather than a higher premium with no cost-sharing.

Medicare screenings

Fortunately, Medicare covers most preventive services, generally at 100%. Covered preventive services include, but are not limited to, cervical and vaginal cancer screenings, mammograms, and bone mass measurements. You can learn more about covered tests and when they are covered on the Medicare website.

Because of their unique health risks, women should compare both types of Medicare plans carefully so they can make an educated decision about their Medicare coverage. Making the wrong decision at initial enrollment could cost thousands of dollars in the long run.