Potential Gaps In Medicare Coverage

The following charts make it easy to see that, even with Medicare, you need additional protection from potential medical costs.

Medicare Part A

When You Are Hospitalized: Medicare Covers: You Pay:

1 to 60 days     Most confinement costs      $716 deductible
                 after the required
                 Medicare deductible

61 to 90 days    All eligible expenses,      $179 per day copayment,
                 after a per-day copayment   or as much as $5,370

91 to 150        All eligible expenses,      $358 per day copayment,
days             after a per-day copayment   or as much as $21,480
                 (These are lifetime
                  "Reserve" days, which
                  can never be used again)

151 days         Nothing                     100% of costs
or more

At least         All eligible expense for    After 20 days,
3 days and       the first 20 days, then     $89.50 per day
enter a          all eligible expenses for   copayment, or as
Medicare-        days 21-100, after          much as $7,160
approved         a per-day copayment
30 days

Note: Your total potential gap in Medicare Part A coverage is $34,726!

Medicare Part B

  When You Incur Expenses For: Medicare Covers: You Pay:

Doctor's Office Visits  80% of all "approved"   $100 deductible
                        charges, after the           plus
Surgeon's Fee           required Medicare       20% of all
                        deductible              Medicare-approved
Anesthesiologist's Fee                          charges
Ambulance Services                              100% of any
                                                excess charges
Speech Therapy                                  above Medicare's
                                                approved amount
Diagnostic Tests

Durable Medical Equipment