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How Senior peoples in States manage their healthcare expenses after retirement?

In Canada, all peoples are covered by Medicare, no matter in which kind of financial positions you are. When you are turning into senior, you are eligible for even more benefits from the Medicare system, ie, big discount prescribed drugs and others. Is it the same thing in the US? If not, do they need buy private insurance to cover the medical expenses after their retirement? That should be very, very expensive!!! How can they manage it? Just curious and hope people from States can share some experience. Thanks.
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