Medicare Out of Pocket Maximum

Maybe you are new to Medicare and wondering if Medicare has an out of pocket maximum, or maybe you’ve had Medicare a long time and just hoped it did!  The truth is that if all you have is just your Medicare card with Medicare Part A and Medicare Part B then you are not protected!  Medicare Part B has no maximum out of pocket.  This means that if you had a major surgery, or were diagnosed with cancer, etc.., your Medicare bills will be Annual Disenrollment Period - Be Aware!like the Energizer bunny and keep going, and going, and going…

Medicare Supplements Offer Protection

Currently, the most protection you can have with Medicare is a Medicare Supplement Plan F.  This Medicare supplement will pay the 20% that Medicare Part B does not pay without a cap.  It will also pay the Medicare Part B Excess Charges while most of the other Medicare supplements will not.  Most supplements being offered today will pay that 20% so just signing up for one will give you some protection.  Medicare Part A also has some holes that could cause some serious damage to your pocket book.  Skilled nursing facility coverage falls under Medicare Part A, and could be quite costly.  While Medicare Part A pays your first 20 days after a 3 nights stay in a hospital; days 21+ could wipe out a nest egg.  The current cost for skilled nursing care under Medicare for 2011 is $141.50 per day, and it will likely increase in 2012.  Medicare Supplement Plan F will pay days 21-100 for a skilled nursing stay as will several other Medicare supplements.

Medicare Advantage Plans Have an Out of Pocket Maximum

Many people are not able to afford a Medicare supplement or may just want to save money by enrolling into a Medicare Advantage plan.  The benefit of this route is that while original Medicare does not have an out of pocket maximum, Medicare Advantage plans do.  This is where you need to exercise do your due diligence when comparing Medicare Advantage plans.  Typically, the out of pocket maximum will vary between Medicare Advantage plans, and sometimes the difference is substantial!  Also, don’t assume that because you are paying a higher premium for a plan that it will offer the best coverage with the lowest out of pocket maximum.  In 2011 there are several plans that have high premiums and a high maximum out of pocket while other plans carry no premium with a low out of pocket maximum.  You can compare plans at www.medicare.gov.

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