All of your medical expenses are NOT covered by Medicare, whether you have a penny to your name once you reach 65 or not. Medical care is a significant expense for seniors. Among the things Medicare doesn’t pay for: long-term custodial care; a portion of skilled nursing facility stays after the first 20 days (the patient pays about $140 per day for the 21st through 100th day, after which the patient pays it all); 20 percent of the Medicare-allowed amount for physician services, x-rays, out-patient procedures, chemo, etc; 45 percent of outpatient mental health care services (currently; Medicare will eventually pay the standard 80 percent). </p>
<p>There are deductibles and premiums. There’s a $1,000 deductible per hospital stay; if that hospital stay exceeds 60 days, the patient pays about $250 per day as a co-pay, and it goes up from there. There’s a $155 yearly deductible for Medicare B (MDs, lab, x-ray, etc.), and a monthly premium of about $95 per person; if you’re high-income, the premium is higher. Many seniors pay big bucks for supplemental insurance because the out-of-pocket expenses are so high. It’s nice if your former employer still covers you, but as others have said, this is changing and many folks are paying for coverage they once expected as a retirement benefit.</p>
<p>Anyone who thinks that Medicare is going to take care of all their medical needs is woefully mistaken. And if you truly don’t have a penny over age 65 and need to depend on Medicaid, you’ll have a tough time receiving decent care. Why save? If you think you’ll need health care once you’re 65-plus, how else will you pay for it?</p>
Really … to travel, to eat out a lot, to visit my grandkids a ton of times, to help my kids and my grandkids with school, grad school, houses, etc.</p>
<p>The person who pays for private insurance-- are they using it as supplemental? In only rare circumstances is Medicare not the primary carrier for people over 65 in the US. If a provider does not accept Medicare they MUST formally opt out of Medicare (every 2 years), even if they were never a Medicare provider. To otherwise accept payment from a Medicare-eligible patient is, per Medicare guidelines, not legal (sounds nuts but thats how it works). Not sure how it works if a provider is OON for Medicare but in network for the private insurance.</p>
<p>My husband has supplemental private insurance to cover what Medicare does not. So he has the medicare premiums, private premiums, Medicare D premiums, and he is still out of pocket several thousand a year on top of the premiums. (he has a lot of health problems). </p>
<p>Here’s a very short explanation (from the Centers for Medicare and Medicaid Services) about Medicare as primary and secondary payer.</p>
<p>This section will provide you with information on Medicare Secondary Payer (MSP) laws and the various methods employed by the Centers for Medicare & Medicaid Services (CMS), formerly the Health Care Financing Administration, to gather data on other insurance that may be primary to Medicare.</p>
<p>Medicare Secondary Payer (MSP) is the term used by Medicare when Medicare is not responsible for paying first. (The private insurance industry generally talks about “Coordination of Benefits” when assigning responsibility for first and second payment.)</p>
<p>The term “Medicare Secondary Payer” is sometimes confused with Medicare supplement. A Medicare supplement (Medigap) policy is a private health insurance policy designed specifically to fill in some of the “gaps” in Medicare’s coverage when Medicare is the primary payer. Medicare supplement policies typically pay for expenses that Medicare does not pay because of deductible or coinsurance amounts or other limits under the Medicare program.</p>
<p>Might I suggest you encourage your kids to immigrate, at least temporarily, to Canada? I sort of kid but I’m also serious for some. </p>
<p>They could work in Canada if they have a NAFTA approved occupation, or go to school up here and roll that automatically into a work visa…in five years of residency more or less, they could get their citizenship (keeping their US one as well…we are all dual citizens in this house). Then in retirement, if they so choose, they could just mosey on up here and not worry about medical expenses. It might just be a nice insurance policy for your kids to consider. Just a thought.</p>