Are you eligible for Medicare?
Original Medicare is a viable health insurance option but you must be aware of the financial risk that comes with just having Original Medicare.
Original Medicare has No Maximum Out-of-Pocket Provision. That means that the sky is the limit for potential costs incurred. What are the major potential costs incurred for Medicare-eligible services rendered? (info below uses 2019 price data)
Medicare Part A:
Deductible and copays are measured per each benefit period
First 60 Days: $1364 deductible
Days 61-90 = $341 co-pay per day
Days 91- 150 = $682 co-pay per day (these are Lifetime Reserve Days, LRD)
All costs for all days after 150 or after 90 if LRD have been used
You have 60 lifetime reserve days to utilize beyond the base 90 days of coverage per benefit period (each lifetime reserve day is exhausted once used). You incur all costs once all lifetime reserve days are used.
Skilled Nursing Home Care
Under certain conditions, Medicare will pay for some skilled nursing facility care.
Days 1-20 = Covered
Days 21-100 = $170.50 co-pay per day
Days 101 and beyond = Not Covered - you pay all costs
Medicare Part B:
Medicare Part B covers medically necessary services and preventive services.
The Standard Monthly Premium is $135.50 or higher depending on your income (note - they use your modified adjusted gross income from 2 years prior).
Annual $185 deductible
Pays 80% of Medicare Approved Amounts
(you pay the remaining 20% balance).
Foreign Travel - Not Covered by Medicare
Prescription Medications - Not covered by Original Medicare, unless administered in hospital or medical office setting.
For more information, including the income-based cost structure for Medicare Part B and Medicare Part D (prescription drug coverage) CLICK HERE.