Health Insurance for Seniors Over 70: How the Main Options Compare

Here's a statistic worth sitting with: seven out of ten seniors turning 65 will need long-term care at some point, according to the Administration for Community Living. And that care doesn't come cheap. CareScout's 2025 Cost of Care Survey puts the national median at $74,400 a year for an assisted living community and $129,575 a year for a private room in a nursing home.

Medicare Part B premiums start at $202.90 a month in 2026, but the choices are complicated. You can pick Original Medicare, Medicare Advantage plans, or Medicaid, which covers 7.2 million low-income seniors, plus various private insurance options.

Below is a comparison of the major coverage options, covering what each one includes and what it costs. If you are already past 70 you are almost certainly enrolled in Medicare already, so the live decisions are different from the ones people face at 65: whether to switch between Original Medicare and Medicare Advantage during the fall Open Enrollment Period, whether a Medigap policy is still obtainable for you, and whether you qualify for help paying premiums.

Original Medicare (Parts A & B)

Original Medicare is the federal health insurance program for seniors. It has two parts: Part A covers hospital care, and Part B covers medical care.

Coverage details

Part A covers inpatient hospital stays, skilled nursing facilities, hospice care, and some home health services. Part B covers outpatient care, medical supplies, and preventive visits. It also includes ambulance services, clinical research participation, durable medical equipment, and mental health treatment.

Costs and premiums

If you paid Medicare taxes for at least 10 years, you get Part A free. Otherwise, you'll pay $311 or $565 a month in 2026, depending on your work history (it was $285 or $518 in 2025).

Part B costs $202.90 monthly in 2026, with a $283 annual deductible (it was $185 a month with a $257 deductible in 2025). After you meet the deductible, you pay 20% of what Medicare approves for covered services.

Hospital stays under Part A have a $1,736 deductible per benefit period in 2026, up from $1,676 in 2025. Your daily costs then depend on how long you stay:

• Days 1-60: $0 after deductible
• Days 61-90: $434 daily in 2026
• Days 91-150 (lifetime reserve days): $868 daily in 2026

Enrollment process

You can enroll in Medicare at 65. Your Initial Enrollment Period runs for seven months, three months before your 65th birthday through three months after. If you get Social Security, Medicare Part A and B enroll you automatically. If you are reading this in your seventies, this window is behind you and the relevant one is the Medicare Open Enrollment Period each fall, October 15 through December 7, when you can switch between Original Medicare and Medicare Advantage or change drug plans for the following year.

If you miss the initial window, you can sign up during the General Enrollment Period (January 1 through March 31 each year). Special situations, like staying on your employer's health plan past 65, may qualify you for a Special Enrollment Period.

Medicare Advantage plans

Private insurers offer Medicare Advantage plans (Part C) to over 34 million people as an alternative to Original Medicare. They bundle hospital and medical coverage into a single plan.

Plan benefits

Medicare Advantage covers all Part A and Part B services and often adds extras like:

• Dental exams and cleanings
• Vision care and eyeglasses
• Hearing tests and hearing aids
• Fitness memberships
• Over-the-counter medication allowances

Provider networks

Medicare Advantage plans limit where you can go for non-emergency care, and network size varies a great deal from one plan and one county to the next. Specialist access, mental health in particular, is often narrower than the primary care network. Look up your own doctors in a plan's directory before you enroll, then call their offices to confirm they still take it.

Prescription coverage

Most Medicare Advantage plans include prescription drug coverage built in, so you don't need a separate Part D plan. These combined plans use tiered drug lists that group medications by cost, making it easier to manage both medical and pharmacy expenses.

Medicare Advantage plans must cap what you pay out of pocket for in-network Part A and Part B services each year, and CMS sets the ceiling on that cap. The actual cap and the monthly premium differ by plan, so compare both on the Medicare Plan Finder for your ZIP code.

Medigap supplemental plans

Medigap is supplemental insurance sold by private companies. It helps pay for the costs that Original Medicare doesn't cover, like deductibles and coinsurance.

Plan types and coverage

Medigap plans are standardized and labeled A through N. Plan G is the one most people choose. The main differences:

• Plan G covers the Part A deductible and Part B excess charges
• Plan N covers most costs but includes specific copays
• Plans K and L cap what you pay out of pocket each year, with percentage-based cost sharing; the cap is reset annually, so check the current figure before you compare

Premium costs

Medigap premiums are not standardized the way the benefits are. The same Plan G costs different amounts from different insurers and in different states, and pricing depends on which of three methods the company uses:

Community-rated plans charge the same premium regardless of age. Issue-age-rated plans base costs on your age when you buy, and those rates stay locked in. Attained-age-rated plans increase your premium as you get older.

Enrollment guidelines

You have a six-month Medigap Open Enrollment Period that starts the first month you have Medicare Part B and are 65 or older. During that window an insurer cannot refuse you a policy or charge you more because of pre-existing health problems. Medicare.gov is explicit that this is a one-time period: it does not repeat every year the way fall Open Enrollment does.

This is the single biggest difference between shopping at 65 and shopping at 75. Outside that window, an insurer is allowed to deny you a Medigap policy if you do not pass its medical underwriting, and you may pay more or have fewer policies to choose from. There are exceptions, called guaranteed issue rights, that apply in certain situations such as losing other coverage involuntarily, and some states give you more rights than federal law does. Check with your state insurance department before you assume you cannot buy one.

Medicare Part D drug plans

Part D is prescription drug coverage offered by private insurers and approved by Medicare. You can get it as a standalone plan with Original Medicare, or it comes built into Medicare Advantage plans.

Coverage options

Part D plans organize medications into five tiers based on cost:

• Tier 1: Lowest-cost generic drugs
• Tier 2: Moderate-cost generics or brand-name drugs
• Tier 3: Preferred brand-name medications
• Tier 4: Higher-cost non-preferred drugs
• Tier 5: Highest-cost specialty medications

Costs and deductibles

In 2026, no Medicare drug plan may have a deductible higher than $615, and some plans have none. You then pay 25% of drug costs until your out-of-pocket spending on covered Part D drugs reaches $2,100. After that, you pay nothing more for covered drugs for the rest of the year.

The national base beneficiary premium is $38.99 a month in 2026, but what you actually pay depends on the plan you pick. Higher-income beneficiaries pay additional charges called Income-Related Monthly Adjustment Amounts.

Pharmacy networks

Plans negotiate discounts at participating pharmacies. Using preferred in-network pharmacies saves $2 to $15 per generic prescription.

Most Part D plans have preferred pharmacy networks, and many offer mail-order options for three-month supplies delivered to your home. Check that your regular pharmacy sits in a plan's preferred tier before you enroll, since the same drug can cost noticeably more at a non-preferred counter.

Medicaid for seniors

Medicaid covers 7.2 million low-income seniors with health insurance and long-term care support. It's a joint federal-state program for elderly people who meet income and asset limits.

Eligibility requirements

Medicaid income and asset limits for older adults are set state by state, and they differ depending on which pathway you apply under, so there is no single national cutoff. Do not assume you earn too much. The limits for long-term care coverage and for the Medicare Savings Programs that help pay your Part B premium are often higher than the ones for regular Medicaid. Apply through your state Medicaid agency and let them run the numbers. To qualify you also need to be:

• 65 or older
• A resident of the state where you apply
• A U.S. citizen or eligible non-citizen

States review eligibility yearly and may ask for more information. Some states have expanded their programs to cover everyone below certain income thresholds.

Coverage benefits

Medicaid covers more mandatory services than Medicare:

• Doctor visits
• Inpatient and outpatient hospital care
• Lab and X-ray services
• Nursing home care
• Medication-assisted treatment

States can add optional benefits like dental, vision, and hearing care. Medicaid funds most long-term care in the U.S.

Dual Medicare-Medicaid options

Twelve million people qualify for both Medicare and Medicaid. For these dual-eligible beneficiaries, Medicaid fills in Medicare's gaps by:

• Paying your Medicare premiums and cost-sharing
• Covering nursing care beyond Medicare's 100-day limit

Medicare pays first for services both programs cover, then Medicaid covers up to state limits. You can choose between Original Medicare with Medicaid or a Dual Eligible Special Needs Plan (D-SNP) if available in your area.

AARP Medicare plans

For a lot of families, AARP is a familiar and trusted name, and its Medicare plans, offered in partnership with UnitedHealthcare, carry that reputation. They tend to rank near the top for the breadth of what they cover.

Plan options

UnitedHealthcare manages three types of AARP plans. Medicare Supplement Insurance helps cover out-of-pocket costs beyond Original Medicare. Medicare Advantage options include $0 premiums for many preventive services. AARP Medicare Rx Plans provide standalone prescription drug coverage.

Member benefits

AARP plans include:

• $0 copays for dental, vision, and hearing exams
• Virtual medical and mental health visits with no copays
• Credits for over-the-counter medications
• Full dental services including cleanings, fillings, and dentures
• Vision care allowances
• Discounts on hearing aids from multiple brands

Plan costs

Costs depend on plan type and your location. AARP charges a $20 yearly membership fee for Medicare Supplement enrollment. UnitedHealthcare's Medicare Advantage plans typically have $0 preventive care premiums.

AARP Medicare Supplement plans are guaranteed renewable, so the insurer cannot drop you for developing a health condition as long as you keep paying the premium. Like all Medigap plans, they carry no network restrictions and no referral requirement. AARP receives royalty payments for use of its name, which support the organization's activities.

Plans are available in most U.S. states except Alaska and territories. UnitedHealthcare sets personalized rates based on your location and chosen coverage.

Blue Cross Blue Shield senior plans

Blue Cross Blue Shield operates as 33 independent regional companies forming the nation's largest health insurance network. Their senior plans reach all 50 states and D.C.

Coverage options

BCBS Medicare plans come in three types. Medicare Advantage options combine prescription drug coverage with wellness programs, adding dental, vision, and hearing benefits. Members typically pay $0 copays for most preventive services and lab work.

Network size

BCBS serves members through 1.7 million healthcare professionals, including:

• Broad physician participation in most states
• Every hospital in their service areas
• More than 63,000 pharmacies nationwide

Plan pricing

BCBS does not publish a single national premium, because each of the 33 regional companies prices its own plans. Get a quote for your ZIP code. Premiums vary by:

• Location and age
• Your coverage choice
• Tobacco use

Premiums adjust yearly based on changes in deductibles, copays, and coinsurance. Some plans waive premiums and drug deductibles. BCBS also runs programs to help low-income seniors reduce prescription costs and close coverage gaps.

Humana senior health plans

Humana is one of the heavyweights in senior coverage, with 5.8 million people enrolled in its Medicare Advantage plans and a lineup built around more specialized needs.

Plan types

Humana offers four types of Medicare Advantage plans. HMO plans cover unlimited primary care within a set network. PPO plans let you visit any Medicare-approved doctor who accepts Humana. PFFS plans set the fees Humana pays providers. SNPs serve people with specific health conditions or dual Medicare-Medicaid eligibility.

Additional benefits

Plans include benefits beyond basic coverage:

• SilverSneakers fitness program access at 15,000 locations
• $25 to $225 monthly allowance for groceries through Healthy Options
• 28 meals delivered after hospital stays through Well Dine
• $0 copays for in-network telehealth primary care
• Free medication reviews through Therapy Management

Cost structure

Once you hit your yearly out-of-pocket limit, Humana covers remaining costs at no charge. Insulin is capped at $35 monthly. Many areas offer $0 premium plans, though rates vary by location and coverage level. Starting in 2025, prescription drug costs max out at $2,000 yearly.

UnitedHealthcare senior options

UnitedHealthcare is the largest Medicare Advantage provider, serving seniors through more than 1 million healthcare providers.

Plan varieties

UnitedHealthcare offers four main Medicare plans. HMO plans work with local doctors and hospitals. PPO plans cover any Medicare-accepting doctor nationwide. PFFS plans have no network limits. SNPs focus on specific health conditions and dual-eligible members.

Coverage details

UnitedHealthcare's 2025 plans include:

• $0 yearly physicals, lab work, and preventive care
• $0 copays for dental, vision, and hearing exams
• $0 virtual medical and mental health visits
• Many Medicare Advantage plans add over-the-counter credits and grocery allowances to help you cover everyday health needs beyond doctor visits. These extras can reduce your out-of-pocket spending and help improve your quality of life.
• Rewards for physical activity and wellness visits

The network is one of the largest in the country, and members can reach doctors at home or while traveling. Check the current directory for your area before enrolling.

Premiums

Premiums depend on location and plan type. Preventive care often comes with $0 premiums. The 2025 formulary emphasizes tier 1 prescription coverage compared to national averages. Members using Optum Home Delivery Pharmacy get tier 1 and 2 medications for $0.

UnitedHealthcare added magstripe technology to its UCard in 2025 for simpler benefit access. Provider search features are improving. HMO and PPO members get broad prescription coverage, with generic drugs staying in tier 1.

Kaiser Permanente takes a different tack as a nonprofit, and it shows in the results: its Medicare Advantage plans routinely earn some of the highest ratings Medicare hands out.

Plan features

Medicare gave Kaiser Permanente plans 4.5 Stars for 2025 in California, Georgia, Hawaii, Maryland, Virginia, and D.C. Colorado, Washington, and Oregon plans received 4 Stars. You get:

• $0 preventive care copays and prescription copays
• Drug coverage without separate hospital or medical deductibles
• Optional dental, hearing, and vision coverage through Advantage Plus
• Fitness programs at partner facilities

Provider network

Kaiser runs coordinated care networks across nine states:

• Mid-Atlantic region
• Washington state
• California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia

Members pick a coordinated care doctor from the network. Most locations offer virtual visits, lab work, and prescriptions all in one place.

Plan costs

Kaiser does not publish a single national premium schedule, and its Medicare plans are sold in only a handful of states. Premiums, copays, and the yearly out-of-pocket maximum differ by state and by plan, so pull the Summary of Benefits for the specific plan offered where you live.

Cigna HealthSpring plans

Cigna Healthcare rounds out the field with Medicare coverage available nationwide, backed by a provider network broad enough to give most seniors real choice.

Coverage options

Cigna has three main Part D (prescription drug) plans. Saver Rx has no or low monthly premiums for generic medications. Assurance Rx is designed for people receiving Extra Help, with moderate premiums and low copays. Extra Rx offers full coverage through a broad pharmacy network.

Extra benefits

Plans include features beyond standard coverage:

• Silver&Fit fitness program and home workout kits
• Customized caregiver support resources
• Post-hospital meal delivery
• 24/7/365 virtual care access
• Pharmacist medication management
• LASIK and acupuncture discounts

Premium structure

Members can choose monthly, quarterly, or yearly payment schedules. Options include:

Electronic Funds Transfer with draft dates from the 1st to 28th of the month. You can also pay quarterly, semi-annually, or annually. Personal checks are accepted, but cash and traveler's checks are not.

The Medicare Prescription Payment Plan spreads costs over the year if you expect to spend more than $2,000 on drugs. MyCigna provides online access to coverage details, prescriptions, payments, and ID cards.

The drug list includes 3,000 common Medicare medications. Preferred pharmacy networks offer discounts through national and regional coverage. This approach balances access and affordability.

Comparison table

Conclusion

Medicare Advantage plans offer dental and vision benefits that Original Medicare doesn't, though they limit your doctor choices. Plan G is the most popular Medigap option for managing out-of-pocket costs with standardized coverage.

Major insurers, UnitedHealthcare, Blue Cross Blue Shield, and Humana, operate broad provider networks and add fitness programs and prescription coverage. Kaiser Permanente has strong Medicare ratings despite serving only nine states. Low-income seniors can get comprehensive coverage through state Medicaid programs.

Premiums span a wide range, from $0 for preventive services to north of $200 for the most comprehensive plans. The right fit really comes down to you: the care you tend to use, the doctors you want to keep, and the medications you take, with your location, health, and budget rounding out the picture.

Open enrollment happens yearly, so you can reassess your coverage as your needs change. The Medicare market keeps expanding with more specialized options for seniors.

Sources

Primary sources for the figures and guidance on this page:

Administration for Community Living - How Much Care Will You Need? - Confirms that someone turning 65 today has almost a 70 percent chance of needing some type of long-term care services and supports in their remaining years.

Centers for Medicare and Medicaid Services - 2025 Medicare Parts A and B Premiums and Deductibles - Confirms the 2025 figures cited on this page: $185 standard Part B premium, $257 Part B deductible, $1,676 Part A hospital deductible, $419 daily coinsurance for days 61-90 and $838 for lifetime reserve days, and Part A buy-in premiums of $285 to $518 per month.

Centers for Medicare and Medicaid Services - Final CY 2025 Part D Redesign Program Instructions Fact Sheet - Confirms the 2025 Part D benefit design: $590 annual deductible, 25 percent coinsurance in initial coverage, and the $2,000 annual out-of-pocket threshold after which catastrophic coverage begins.