I work for a health insurance company and I do customer service for the Medicare suppliments that we sell.
When you turn 65, you will pick up Medicare Part A, which is inpatient (IP) hospital insurance. It only pays for IP hospital stays. Your bill would be paid at 100% minus the IP deductible, which is currently $1260...you will need supplimmental insurance to pick up the $1260.
You will also purchase Medicare Part B, which is health insurance for all providers, including, doctors, emergency room and all outpatient services, lab work, x-rays. Medicare will pay 80% of the allowed charges and you will be responsible for the 20% coinsurance. Some states also allow the providers to charge the excess fee (the amount not allowed my Medicare. You will need supplimental insurance to pick up the 20%, plus the excess fee if you live in a state where it may be charged.
A supplimental policy is purchased to work in tandam with Medicare. The supplimental policies are exactly the same in all 50 states and from every insurance company that sells them....only the price is different.
If you want traditional Medicare and supplimental insurance, choose Supplimental Plan C if you live in a state that does not allow the providers to charge the excess fee. Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island and Vermont
If you live in a state that allows the provider to charge the excess fee, choose Supplimental Plan F.
Both Plan C and F cover fees for inpatient rehab or skilled nursing in a facility (SNF). Without these supplimental plans you would be responsible for $157.50 a day for day 21 to day 100 if you need long term care in a skilled facility. (My sister is currently in a SNF with a broken hip and she is fortunate to have Plan F) They also cover foreihn expenses....Medicare does not. If you travel or cruise, it's important.
If you wish to ditch Traditional Medicare and choose an Advantage plan like an PPO or HMO, they differ state to state. You would be giving up your Traditional Medicare and would only have the insurance plan you have chosen. If you want to go this route, be careful. You could get stuck with very high medical bills for non-covered services. Some of these plans include dental and offer perks such as health club memberships. The cost is much lower than Traditional Medicare and Supplimental plans.
Traditional Medicare and the supplimental plans to go with them do not offer dental or long tern care to help you at home or in a SNF. Home health care for medical services are covered though. Routine care and meal prep, etc is not covered.
Long term care is very expensive. I had the opportunity to purchase long term care when I was around 42. It was almost $400 a month and was guaranteed to remain at the same price forever as long as I paid the priemium, I passed, I can't imagine what it would cost at age 65.
I plan on choosing Traditional Medicare Plan A,B and C....and also Supplimental Plan C when I turn age 65.
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