Quote:
Originally Posted by LoriAnn
As you stated, you've done your research. Live with it a little while. Some lessons you have to learn on your own. Your rolling the dice anytime you opt out of traditional Medicare. If you don't have a serious illness such as a heart attack or a stroke and require long hospitalization, rehab, homehealth, DME you may come out with a savings. Another example of a policy that works great until you get sick.
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I HAVE done some research and here is what I found regarding some of the scenarios you pointed out. The figures I am presenting here are for Original Medicare with no supplemental insurance, and the advantage plan I have, which is Preferred Care Partners Gold Plan
A "long hospitalization" (I'm using the time limits on the Medicare website and the Preferred Care partners 2012 coverage booklet) of 150 days:
If all I have is Medicare I would pay out-of-pocket $43,582
PCP..........I would pay $350 co-pay, total, for the first 7 days only. No limit on additional days.
Rehab in skilled nursing facility:
Medicare: $0 for days 1-20
$ 141.50 per day, for days 21-100
Total for 100 days=$11,320 out-of-pocket
PCP: $0 for days 1-10
$ 50 a day, for days 11-20
$ 75 a day, for days 21-100
Total for 100 days $6500 out-of-pocket
Home Health Care coverages are the same and the costs are the same, $0.
Medicare pays 80% for out-patient rehab
PCP has a $25 co-pay
Hubby has required Durable Medical Equipment for 15 years for his sleep apnea. When we had Medicare and a supplemental policy that we paid extra for our cost was $0. On PCP our cost is $0.
Now, if one wants to buy a supplemental policy that will pick up the 20% that Medicare doesn't cover that is an extra cost every month. When we left AARP United Health Care supplemental coverage last year we were paying $200 a month ea. for medical and drug coverage. PCP includes drug coverage at no cost and it is every bit as good as what I was paying almost $40 a month for. PCP will be returning $75 to me in 2012, every month, for the Medicare Part B premium. If I stay reasonably healthy I will have an extra $3300 a year in my savings account. (Yes, we tuck away the savings we are realizing every month). If, worst case scenario I have a serious illness, I have a $5000 out-of-pocket maximum.
As for not being able to go to any doctor I want, or not receiving good medical care in the future should I need "specialists", etc., there are many good and qualified doctors on the PCP provider list. As far as I am concerned the care I have received from the PCP doctors has been as good, and maybe even better as what I got when I was paying the big bucks.
We could all go on debating this issue for years, and we probably will. In the end, we have to educate ourselves and then make the best decision we can about our health care coverage.