05/10/2024
We are receiving a lot of calls about this post being shared. Here are some facts!
As a licensed insurance agent specializing in Medicare insurance. I would like to educate people on their options.
Original Medicare doesn’t require prior authorizations that is correct, but it does require the patient to pay a Part B deductible of $240.00 and 20% of all bills. If they are admitted to the hospital they have to pay Part A deductible $1,632.00 plus 20% of all services. If they are in the hospital more than 60 days they pay $408 a days 61-90 plus the 20% that is of life time reserve days. Original Medicare doesn’t have a cap on yearly medical cost. Skilled nursing they get 21 days for free then they start paying co insurance up to 100 days. They also need a drug plan to cover their medications. Most drug plans have a $590.00 deductible and then they pay copays when they pick up their medication from the pharmacy. To avoid this patients need to have a supplement and drug plan or an advantage plan.
Original Medicare, supplement and drug plan cost people around $500.00 a month when most people only bring home $1,500 a month to live on. That would leave them $1,000 a month for food,utility bills, gas, car payment, car insurance, mortgage, home insurance, medication copays etc. The supplement will cover their 20% after they have met their part b deductible of $240.00. Medicare has to pay before a supplement will pay.
Advantage plans are not all the same. There are HMO and PPO plans in our area. The premium depends on the plan. Advantage plans turn the 20% into affordable copay amounts, have a maximum out of pocket on medical cost, include drug coverage without an additional premium,no or lower drug deductibles, and most include dental, vision, hearing, gym memberships etc.
With all that said everyone’s needs are different and that’s why people should talk with a LOCAL Medicare insurance specialist to see what plan covers their individual needs.
