Anonymous
Anonymous asked in Business & FinanceInsurance · 2 months ago

I am on medicare with Plan A & B.,Why would I still need a supplemental plan ?

7 Answers

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  • 1 week ago

    Medicare DOES NOT cover everything at 100%. Imagine paying 20% of a serious illness or condition. Plus, there is no out of pocket Maximum with Medicare, so you could pay tens of thousands of dollars in coinsurances.

    So, Yes, you do need additional coverage. Does it need to be a supplement? Not necessarily. However, supplement coverage is the most comprehensive option available. If it's not affordable in your service area, at least try Medicare Advantage, with a maximum out of pocket on most plans being around $6,000; you'll have more protection than with just Medicare.

    The best Medicare Advantage plans aren't as comprehensive as Medigap, but some coverage is better than no coverage.

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  • Judy
    Lv 7
    2 months ago

    They only pay a %, Supplement pays some of the rest.

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  • 2 months ago

    Because Medicare covers up to 80% of billed charges, and usually less than that. So you are responsible for what they dont pay. A Medigap policy will cover the unpaid balance so you dont have to.

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  • 2 months ago

    You don't "need" it, but it does make sense to want it to offset costs of what Medicare doesn't cover.

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  • Judith
    Lv 7
    2 months ago

    Can you afford to pay the 20% not covered by Medicare and the deductibles?  I sure couldn't.  Between Medicare and my supplemental insurance all medical costs are covered except for a $45 charge when I get my eyes examined.  As you age your need for medical care increases.  Tests and surgeries are expensive and could break the bank.  If you can afford supplemental insurance you would be wise to get it.

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  • 2 months ago

    Because Part B pays 80% of what Medicare allows. You pay the other 20%. Let's say you need emergency surgery. The hospital charges $12,000 and Medicare allows only $7,000. The hospital must accept the $7,000 if they want the business of the millions of people with Medicare. There's no premium for Part A, but there is an annual deductible of $500. You pay that and Medicare covers the rest.

    There are going to be a bunch of other bills, the surgeon, your own doctor, the anesthesiologist, any other doctors you see. Medicare will send you statements for all of them, showing you the actual charge and how much they allow. Let's say the total of what they allow is $10,000. You are going to owe $2,000 of that.

    So this surgery just cost you $2,500. Got that much?

    You'll have other bills during the year, too, you pay 20% of what Medicare will allow.

    Now, if you got a Medicare Advantage plan like my wife just signed up for...she has no monthly premium. For the same exact surgery, she would pay a hospital copay of $375 per day for the first five days. The average stay is only 2 or 3. She pays the surgeon $200. Any other bills related to her time in the hospital are covered 100%

    The surgeon copay is up $50 from 2019. This past year she dislocated her elbow. Did not require a hospital admission. She paid $150 for the facility copay. The two different doctors that treated her sent bills that totaled about $2,500. She paid nothing

    There are also Medigap plans, which are not the same as Medicare Advantage plans, and I don't know that much about them but I don't think they offer as much.

    Another thing to watch out for if Medicare is your only coverage is you need Part D for prescriptions. You need it. If you did not go straight from coverage under a qualified plan (such as an employer plan) to a Medicare Advantage Plan, if you sign up for one, the company will ask you for proof that you had Part D coverage, and they will charge you the premium for it, because Medicare will be asking them for it. If you don't have Part D and you are more than three months past turning 65, then you will pay a premium penalty on Part D.

    It's too late now to sign up for anything, open enrollment ended today. January 1st, there will be another enrollment period until March 31st, but your coverage will delayed until July 1st. You don't pay until July, but you will have no coverage other than your basic that you have now.

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  • Murzy
    Lv 7
    2 months ago

    Medicare doesn't pay for everything.

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