Medicare is a pretty good insurance plan but it has some big gaps and no cap on a person’s medical bills. For 2010 the Part A deductible will be $1,100. This means, if you go into the hospital you must pay $1,100 of the hospital bill and Medicare pays the rest…EXCEPT for doctors’ fees. Doctor fees come under Part B of Medicare, which has a $135 deductible. After you pay this deductible Medicare will pay 80% of your doctor bills. You must pay 20%.
I have heard many stories of people who have “just Medicare” and have run into big medical bills. Here is an example:
I got a call recently from a man in Bullhead City, AZ who lives on $1,100 per month and has Medicare. He was recently rushed to the hospital and spent a week getting treatments for a liver problem. Medicare paid all but $1,068 (2009 deductible) of his hospital bill, but he has to pay 20% of the bills for the surgeons and doctors who treated him during his hospital stay.
He told me he now owes thousands of dollars in medical bills, which he cannot pay. He still needs treatment, but doctors and labs have told him he needs to pay his 20% upfront or they won’t see him. Needless to say, he hasn’t got the money and is not getting treatment and tests he needs.
This example shows that Medicare alone is not adequate coverage, as 20% co-insurance can easily add up to thousands of dollars. And Medicare has no limit on what a patient might pay for their 20%.
I know Democrats hate Medicare Advantage, but these can be helpful for a person like this man who is on a limited income. With most Medicare Advantage plans, his costs would have been limited to between $600 and $1,000 for his hospital stay. And he could see a specialist for treatment for about $40. He could get the care he needs if he were enrolled in a Medicare Advantage plan.
As usual, when it comes to arguments for and against something, the truth lies somewhere in the middle.