By Alex Rosenberg | NerdWallet
About 41% of Original Medicare beneficiaries had Medicare Supplement Insurance, or Medigap, in 2021, according to a February 2023 report summarizing enrollment data from AHIP, a national health insurance trade association. For the other 59%, Medicare has some “gaps” that could be costly.
“There are many gaps in Medicare that a beneficiary has to pay if they don’t have a Medigap,” Kelli Jo Greiner, Minnesota State Health Insurance Assistance Program director, said in an email. “This can add up to be thousands of dollars per year.”
While it’s not mandatory, you might want to purchase a Medigap policy to fill some of the gaps in Medicare Part A and/or Part B. (Medigap doesn’t work with Medicare Advantage policies.)
Deductibles
Medicare Part A has a deductible of $1,632 in 2024, which you owe before Medicare starts to pay for inpatient hospital care.
“Just one hospital stay, you’re going to be paying that $1,632 deductible — so, really fast, your costs can add up,” says Joanne Giardini-Russell, CEO of Giardini Medicare, an independent insurance agency.
Most Medigap plans cover the Part A deductible. And plans with premiums below $136 per month could put you ahead based on that benefit alone.
(New Medicare members can’t buy Medigap plans that cover Part B’s relatively smaller deductible of $240 in 2024, so you’d still owe that amount out of pocket.)
Coinsurance and copays
After you’ve met your deductible, there are out-of-pocket costs for many Medicare services. For example, you pay a 20% coinsurance for most medically necessary outpatient services covered by Part B.
Medicare Part A copays kick in after your 60th day in the hospital. They start at $408 per day in 2024 and get more expensive for longer stays.
All Medigap policies include at least some coverage for Part A and Part B coinsurance and copays. If you use a lot of health care, that coverage could mean big out-of-pocket…
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