Free video guide to Medicare Plans and Options including Medicare supplement information. Important Medicare insurance and health care answers for seniors, caregivers, the eldery and those approaching retirement.
Y0066_101006_100449 File & Use 10112010
MEDICARE COVERAGE RISK
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. Medicaid is often the result for those that face catastrophic medical situations. Medicaid eligibility requires a limited amount of assets such that the term "spend-down" is used to describe what happens when one is selling/losing assets to become Medicaid-eligible.
What are the major potential costs incurred for Medicare-eligible services rendered? (info below uses 2017 price data)
Medicare Part A:
Deductible and copays are measured per each benefit period
First 60 Days: $1316 deductible Days 61-90 = $329 co-pay per day Days 91- 150 = $658 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 = $164.50 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.
Annual $183 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.
Solutions For Helping With Medicare Healthcare Costs: