Do I really need a Medicare supplement plan? You and 25 million others ask the same question. The answer is, you don’t NEED a Medigap plan but you will probably want one.
GA Medicare expert Bob Vineyard explains.
Table of Contents
Original Medicare – Good and Bad
Original Medicare Part A, the hospital inpatient portion, does not charge a premium to most people. Other than the per admission deductible ($1364 in 2019) you will not have out of pocket expenses for most hospital stays. This applies if your hospital admission does not exceed 60 days and Medicare approves all hospital billed charges.
Charges by a surgeon or other non-staff member usually fall under Medicare Part B. The same is true for ER charges and expenses incurred when admitted for observation.
Medicare Part B is for outpatient health care charges. You are not required to enroll in Part B but you probably want to. Large claims exceeding $40,000 often have over half the total incurred on an outpatient basis.
Medicare Part B requires a premium payment. In 2019 the premium for most people is $135 per month. Part B has a yearly deductible ($185 in 2019). Above the deductible Medicare pays 80% of approved charges, you are responsible for the 20% balance.
There is no cap on your out of pocket expenses for Parts A or B.
A Medicare supplement plan will greatly reduce your out of pocket expenses for Parts A and B charges. Most buy a supplement plan for two reasons.
First, they are able to keep their doctor. No, this is not a campaign pledge. You really CAN keep your doctor(s). Also you are free to use any doctor or hospital in the U.S., penalty free.
Second, a Medigap plan allows you to budget future health care expenses. No worrying about unexpected large medical bills.
Late Enrollment Penalties
The best time to enroll in Medicare is when you are first eligible. Medicare does grant a “free pass” in SOME situations when you enroll late. Make sure you understand the rules.
If you don’t qualify for no premium Part A you will incur late penalties if you fail to enroll on a timely basis.
Likewise, Medicare Part B has late penalties which can be waived in some situations. If you are charged a Part B late penalty you will pay it for life.
There are no late enrollment penalties for failure to enroll in a Medigap plan but there can be consequences. If you miss your initial enrollment or special enrollment period you will have to qualify medically for coverage. The decision is pass/fail. Either you qualify or you don’t.
How Much Does Medicare Cost?
Unless you have enjoyed “free” insurance up until now, you will probably find that original Medicare and a Medicare supplement plan are real bargains.
No provider networks. Never any non-par penalties or hidden provider charges.
You have questions. We have answers. Never any charge.
All I ask is that you allow me 10 minutes on the phone to answer your questions. If you like what you hear and believe I can help, then great.
If not, you walk away and we part as friends.
I call it an offer you can’t refuse.
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