What Does a Medicare Supplement Really Cover?
Everyone will say, “It fills in the Medicare coverage gaps” or “it covers what Medicare doesn’t” In fact, I’ve said those mantras to my clients many times. But when you’re looking at paying $80-150 in premiums per month for one of Medicare’s more popular and comprehensive plans, that’s not enough of an explanation.
Retirees like you have a lot of things pulling for your cash. And when you’re living post full-time employment, money can be tight. It can even leave you wondering if a Medicare Supplement is really worth it. For that reason, I think it’s time to take a closer look and see what that monthly premium is really paying for.
I have addressed Medicare’s most costly coverage gaps below. Do the most popular Medicare Supplements (F, C, G, D, and N) pay for them?
20% Coinsurance on Part B
For outpatient coverage like lab tests, doctor visits, and surgeries (any care received while not admitted to a hospital), Medicare covers 80% of the costs. A Medicare Supplement picks up where Medicare leaves off, taking care of the other 20%. The only popular plan that doesn’t cover the 20% in full is Plan N, but Plan N only leaves a couple small copays of $20 for office visits and $50 for trips to the emergency room.
If you are thinking of a $100 x-ray, the 20% isn’t a big deal. But what about a $20,000 outpatient surgery? What about $150,000-200,000 on chemo-treatments, like my father-in-law experienced? Then you start to understand why this is such an important benefit.
$1340 Part A Deductible
Before Medicare pays anything on inpatient care, you have to meet a $1340 deductible, sometimes more than once per year. All of the popular Medicare Supplement policies cover the Part A deductible in full.
Medicare pays for the first 60-days of your hospital stay (after the $1340 deductible, of course). However, you will have to pay $335 per day for days 61-90 and $670 per day for days 91 and beyond (these days do not necessarily need to be consecutive.) Again, all of the popular Medicare Supplements cover this in full.
Without a Medicare Supplement, a 120-day hospital stay would cost you over $30,000 in out-of-pocket costs!
Skilled Nursing Coinsurance
Medicare pays for the first 20 days. For days 21-100, you pay $167.50, and for 101 and beyond, you pay all the costs. Yet again, all of the popular plans cover every dime of this coinsurance amount for days 21-100.
And all of these benefits are just the foundation of what makes a Medicare Supplement such an attractive option for retirees. Many plans cover a lot more than what I’ve addressed here. For instance, a Plan F (Medicare’s most comprehensive and popular supplement plan) covers, well, almost everything. Assuming a procedure is Medicare approved, you will have no out-of-pocket expenses with a Plan F.
That is why, although they are not right for everyone, I often recommend them to my clients. They really do “cover what Medicare doesn’t” and “fill in the Medicare coverage gaps,” as it has been said so many times. Of course, no one wants to pay the monthly premium, but in the end, you get what you pay for. For most retirees, the peace of mind to know that they will never get stuck in one of those huge Medicare coverage gaps is worth it.
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