If you only have Original Medicare, you have substantial coverage in the hospital as well as in the doctor’s office. This is not enough coverage for many Medicare Beneficiaries, however. If you only have Medicare Part A and Part B you may have a lot of expenses to pay that Medicare will not cover.
Medicare Part A provides coverage for hospital charges primarily but doesn’t cover all expenses. You will have a deductible of $1,132 in 2011. This is not an annual deductible. This is a per-benefit period deductible. This means that you could pay it more than once per year if your hospital stays are more than 60 days apart. You may also incur substantial per day charges in the hospital if you need care for more than 60 days in a benefit period.
Medicare Part B primarily covers physician charges outside of the hospital, but this coverage is far from complete. You will have an annual deductible of $162 in 2011 for Part B services. In addition to this you will be responsible for at least 20% of any charges in excess of your deductible. If your doctor doesn’t accept assignment, you could be responsible for a higher percentage of his or her fees.
You can avoid most of this liability by purchasing a Medicare Advantage policy that covers prescription drugs (most do). You may also get more comprehensive coverage by purchasing a Medicare Supplement policy with a separate Prescription Drug Plan.
We can help you with decisions about all of the above. Please give us a call at 203-374-3645 or 1-800-INSURANce if you would like for us to help you explore options for senior health insurance (as well as health care insurance for other Medicare Beneficiaries.)