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A guide for helping retirees navigate the healthcare system

The US Healthcare system can be challenging for many patients, especially retirees. Learn how to assist older patients with medicare and other medical challenges.

helping retirees navigate the medical system

At a Glance

  • Navigating healthcare in retirement is complex, costing up to 15% of retirees’ income; physicians play a key role in guidance.
  • Medicare offers multiple options for coverage; doctors should help patients understand these plans and their influence on care quality.
  • Preventative screenings and proactive healthcare measures are crucial; doctors should educate retirees and their caregivers on these aspects.

According to the 2020 United States Census, 1 out of every 6 adults in America is 65 or older and considered retirement age. While retirement is ideally a time to relax and pursue one’s passions, navigating the healthcare system at this stage of life can be challenging. Doctors are uniquely poised to help retirees understand their healthcare options.

The challenges of rising medical costs 

Healthcare costs continue to rise, and medical care could cost up to 15% of an average retiree’s income as they age. Some studies report that up to 80% of retirees are concerned about how they will pay for healthcare. Since aging adults may need additional medical care as they age, retirees and their loved ones must learn how to navigate the healthcare system.

Helpful information doctors can relay to retirees

Independent doctors offer more than just medical care; they also create accessible and transparent environments to guide retirees through the complexities of healthcare. By encouraging regular screenings and treatments for age-related conditions, physicians can help to inform retirees’ choices about optimal medical coverage. Transparency about accepted insurance types is particularly vital, as coverage directly influences the quality of patient care during retirement.

Healthcare during retirement

In retirement, patients should select healthcare coverage that pays for all of their medical expenses. Many retirees opt to receive Medicare as their base healthcare coverage. They can purchase additional insurance to cover the remaining healthcare costs. 

As a doctor, it’s essential to inform your patients whether or not you accept Medicare — 97% of practices in the United States do — and to let them know how changing their medical plan may affect their ability to pay for care. 

What is Medicare?

Medicare is health insurance provided by the federal government for any individual who is age 65 and older. There are 4 parts to Medicare, and each covers different kinds of services:

  • Part A: Covers hospital stays, nursing home care, and some home healthcare services. Medicare Part A is public, and most individuals do not pay a monthly premium. Those not eligible to receive this coverage for free can choose to purchase it.
  • Part B: Covers some doctor’s appointments, including preventative services, outpatient care, and medical supplies. Medicare Part B is public, but all recipients pay a set monthly premium that changes yearly. 
  • Part C: Otherwise known as Medicare Advantage, these private insurance plans cover Medicare Part A and B but may offer additional benefits such as vision and dental. Retirees must pay for these plans. However, be aware that if a patient opts for Medicare Advantage, there could be downsides, including being unable to stay with the same doctor or having increased costs. Encourage patients to double-check their insurance eligibility before switching plans to avoid unexpected expenses.
  • Part D: Can cover prescription drug costs. Medicare Part D plans are private and offered by healthcare insurance companies contracted with the federal government. 
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Preventative healthcare for seniors

Preventative healthcare can look different for retirees. Aging patients must be more proactive to catch symptoms before they become problems.

Recommended health screening for patients over 65 include:

  • Breast cancer screenings, including mammograms
  • Bone density testing as a screening for osteoporosis
  • Regular PAP smears to screen for cervical cancer
  • Abdominal aortic aneurysm screenings, especially for former smokers 
  • Prostate cancer screenings
  • Testicular exams

A patient’s healthcare coverage can influence their decisions on what, if any, preventative care measures they take. Since Medicare covers many of the recommended services and screenings for retirees may need, healthcare practitioners should encourage patients to be proactive and opt for preventative screenings. 

In addition to the care listed above, preventative healthcare for seniors consists of regular wellness checkups, visual and dental appointments, and screenings for common health conditions that develop later in life.

Top health conditions among retirees

Some of the most common health conditions among retirees include the following:

Remind your patients that proactive and preventative medical care can help mitigate the symptoms and severity of many of these healthcare conditions. 

Healthcare finances in retirement

The average couple over 65 is estimated to spend $315,000 in healthcare costs, not including long-term or in-home care. Many retirees pay for these costs through insurance, Social Security, and savings.

While doctors cannot act as financial advisors, you can emphasize to patients the ways that preventative care can save money in the long run. In addition, being transparent about billing practices, what insurance their practice takes, and having clear and informative patient statements can help you to actively advocate for older patients. 

Information for healthcare providers

As a doctor, you can be a vital resource for retirees navigating the healthcare system. One of the ways to do this is to create an accessible, and transparent welcoming environment in your medical practice so that you can provide the best experience for retirees. This starts by acting as a resource for patients who have questions about Medicare. 

Medicare and your practice 

Doctors should have a solid grasp on how patients can most effectively use Medicare to offset their healthcare costs. Part of this comes from work within your practice. Your staff should have a strong foundation on Medicare billing and know how to process Medicare alongside other insurance claims. While a patient’s final medical plan decision is their own, your independent practice can act as a liaison between retired patients and insurance brokers. Consider implementing the following in your practice: 

  • Offering clear resources on the types of insurance your practice takes and what types it does not, including a breakdown of how Medicare Advantage plans may change a patient’s healthcare options
  • Working to increase patient insurance literacy
  • Partnering with organizations to offer workshops about selecting healthcare coverage, including advice on how to avoid insurance scams
  • Hiring medical staff who are knowledgeable about Medicare and can help take retirees through their medical expenses if they have questions

Accommodating elderly patients

Accessibility on digital, physical, and professional levels is paramount to providing a best-in-class experience for retired patients. 

Technology and elderly patients

It’s important to recognize that elderly patients may be unable to effectively use digital health tools if they are not taught how to do so. While most seniors prefer in-person care, many of them may choose to use telehealth services, especially if they have restricted mobility or have a provider that they trust. 

The key is providing guidance and education to retired patients on using these services to their advantage. For example, telling patients that completing intake forms online can help them save time at the office is an excellent way to showcase how technology can benefit them. 

Offering printed guides to patients on navigating technology, demonstrating how to use technology during an appointment, and walking a trusted caregiver through the process can go a long way toward accommodating an older patient’s unique needs. 


Creating an accessible medical practice can involve the following: 

  • Optimizing your practice’s physical environment by meeting or exceeding ADA guidelines and purchasing exam room equipment that is accessible
  • Emphasizing comfort, especially in your waiting room
  • Offering an accessible medical practice website
  • Being transparent about offering interpreters and resources for individuals with visual or auditory disabilities
  • Always putting the patient first and asking what they need

Providing these accessibility measures benefits everyone who visits or works in your practice, regardless of ability.

Tips for Communicating With Older Patients

  • Recognizing your patient as an individual adult and approaching all topics with maturity
  • Addressing the patient directly, rather than speaking to their caregiver or family member
  • Allowing plenty of time for conversation and not rushing through discussion
  • Speaking plainly and clearly and making eye contact
  • Being aware of and accommodating visual and auditory impairments and cultural differences
  • Providing handouts and written information to emphasize critical takeaways from the appointment

This last step is vital for doctors who instruct patients on how to take medications safely.

Medications and seniors

Aging patients are increasingly likely to need medication to help manage their health conditions. This, in turn, can raise the potential for possible harmful medication interactions or missed doses, especially if a patient has many prescriptions. As a healthcare provider, there are a variety of ways that you can ensure that your aging patients are safely taking their medication, including: 

  • Being knowledgeable about how medications work differently in aging adults
  • Helping patients create a medication list, including what, how many, how often, and why they need to take specific medications
  • Informing patients about potential side effects and when they should reach out for assistance if they have concerning symptoms 

Some patients may also be concerned about whether they need specific medications because they cannot afford them or are unsure if their insurance will cover them. Providing this information can also go a long way toward creating a good patient experience.

Working with family members

Fostering relationships with a retired patient’s family and caregivers can improve their quality of care. While family members may feel unprepared or even at odds with healthcare providers, their involvement offers a more comprehensive view of the patient’s everyday life. They can act as intermediaries, and can facilitate crucial conversations about preventative care, current medical needs, advanced directives, and end-of-life wishes. 

As always, the patient should make their own choices about their health. But physicians should also recognize the emotional demands and time commitment of caregiving. Providing caregivers with essential information and mental health resources can fortify the healthcare partnership. 

Providing a better experience for retirees

Retirees may need help navigating the healthcare system due to the myriad healthcare logistics of aging. As such, patients may see you as an essential resource that provides them with healthcare but can also help decode the complex system of insurance billing, coverage networks, and healthcare costs. 

Addressing your retired patient’s concerns is an excellent first step, and providing reputable resources is another. Finally, having a solid foundation in how aging bodies are different is essential, especially as many physicians receive no training in geriatrics at all. It is crucial to see aging adults as individuals and be actively anti-ageist when providing healthcare and working to create an age-friendly healthcare system. 

Keeping these tips in mind, it’s possible to provide an accessible, transparent, and welcoming medical practice for retirees. 

Additional resources for understanding aging patients 

These resources can be a starting place for physicians looking to improve their knowledge about making a welcoming environment for retirees. Many of them can also be distributed to patients and caregivers. 

  • Alzheimer’s Association: Resources for those with Alzheimer’s and those who love them.
  • American Society on Aging: This organization aims to destigmatize aging and create a more age-friendly society for everyone. 
  • American Academy of Physicians Toolkit for Caregivers: An extensive list of resources to connect caregivers with the emotional and financial support they may need while helping them understand how to provide the best care for their loved ones. 
  • Centers for Medicare and Medicare Services: This government agency manages the Medicare system and provides details and resources for physicians about their obligations when accepting Medicare insurance. 
  • Health in Aging: Created by the American Geriatric Society, this website is an in-depth, reputable resource to learn about healthcare conditions, medications, and vaccines. 
  • The general health insurance marketplace for those shopping for insurance plans. Remember that patients must drop their Medicare coverage to shop for projects on the Medicare website.
  • The Medicare website provides information on what is covered and what isn’t and allows retirees to enroll. 
  • National Council on Aging: Provides various resources for older adults, caregivers, advocates, and medical professionals. 
  • Older Americans and Medicare Scams: Unfortunately, scammers often target older adults to take advantage of them. This Federal Trade Commission Resource overviews Medicare scams and how to prevent them.
  • The Real Cost of Healthcare in Retirement: An overview of different considerations to consider when planning for retirement healthcare.
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Jean Lee, managing editor at The Intake

Jean Lee is a content expert with years of journalism and marketing experience — along with a constant passion to help and engage others through storytelling. She is the managing editor at The Intake, and is excited to support independent practices with content, insights, and resources that help them thrive.

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