Is original Medicare enough medical coverage for a senior?

By | March 13, 2017

by Steve Keefe, President of Medicare Your Way LLC

You’re approaching your initial election period (IEP) for Medicare which is normally when you are close to turning age 65. You could already be on Original Medicare, and the main question most want to know; “is Original Medicare sufficient medical coverage”? Answer – Probably not. There are various Medicare supplements available and also Medicare Advantage, but are they really necessary? In most cases, yes…..

Most Don’t Rely on just Original Medicare 

Most Medicare Beneficiaries don’t think Original Medicare is comprehensive enough without supplemental coverage. In fact only 14% of all Medicare eligible beneficiaries rely on just Original Medicare, without any additional public or private coverage. If you have significant financial resources and you are willing to risk spending a large amount upon an unforeseen illness, you could rely on just Original Medicare. Your biggest financial risk is no cap on how much you have to pay for out of pocket expenses. It also doesn’t cover prescription drugs cost. Those are covered under Part D of Medicare.

Although most hospitalizations last less than one week, if you were hospitalized like my mother was in 2010 for 131 days, you would be responsible under Part A (Hospital Insurance) of Medicare during the first 60 days for only $1,316. However, days 61-90 would cost you $9,870 and days 91-131 would cost you $26,320 totaling $37,506 for a 131 day hospital stay. Not everyone has money earmarked for these exorbitant amounts of medical bills.

Your biggest risk of only having Original Medicare is with Part B. You only have a $183 deductible in 2017, however you are responsible for 20% of all remaining costs. I just had a customer compile a $998,000 bill of which you would be responsible for $199,600. Again we not only don’t plan on serious illnesses but most don’t have those sums of money set aside for medical bills.

If you never get seriously ill and only need coverage for the occasional doctor office visit then you would be fine with just Original Medicare. Who has a crystal ball to predict their future medical or lack of medical issues? If you’re feeling lucky then this would be a good strategy, otherwise I would recommend either a Medicare Supplement or Medicare Advantage Policy to help reduce your out of pocket claim risk.

There are affordable plans available for Secondary Coverage

Medicare Supplements run from $50-$130 per month depending on which plan you would choose and there are Medicare Advantage Plans from zero premium up to $79 per month. You can get a Part D prescription drug plan for as little as $15 in 2017. I would encourage you to research a trusted independent advisor that specializes in helping seniors with Medicare. You may contact Steve Keefe, President of Medicare Your Way, LLC for help as well @ 317-372-3070. If you would like more information call Steve or you may view the attached  2 minute video link, which talks about Original Medicare and supplemental coverage options.

Good Luck!