Do You Need Supplemental Insurance with Medicare? Pros and Cons



Even if you are a healthy person, it is always a good idea to have supplemental insurance. In the event something major happens, or an unforeseen illness or injury occurs, you will have the peace of mind in knowing you are covered. Do you need supplemental insurance with Medicare? The answer is up to you as to whether you are willing to take large financial risks. It’s certainly worth looking into.

Deductibles and coinsurance

Let’s consider just for a minute that you go to the hospital 4 times in one year. That’s once every 3 months. This year’s deductible is $1100 and renews every time you stay out of the hospital 60 days. That would mean $4400 in deductibles alone. Medicare graciously pays the majority of the rest of your hospital bill. Now, you have physician visits, routine services and other medical needs that happen throughout the year. The coinsurance for outpatient services is an 80/20 ratio. Medicare pays 80%, while you pay 20%. That means that any lab work, physician visits, x-rays or anything else outpatient you are required to pay 20% of those charges. Those bills can add up quickly.

Beyond reserve days

Medicare uses a dwindle-down system. They pay the majority of the medical bills, but only for so long. After so many days, their portion gets smaller and yours gets larger. The last ditch effort on Medicare’s behalf are reserve days. These are the last few days Medicare will pay anything for hospitalizations. After Medicare pays the reserve days, benefits are exhausted for hospital care. That means the bills are now 100% your responsibility.

Supplemental Insurance to the rescue

The portions that are left in the wake of Medicare could be taken care of if you had supplement insurance. This insurance is designed to pick up portions or all of what Medicare leaves behind in deductibles and coinsurance. Between the two insurances, there isn’t much, if anything, for you to pay. You simply pay your premiums for having the insurances.




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