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Financial bankruptcy with medicare?
Old 11-01-2010, 08:30 AM   #1
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Financial bankruptcy with medicare?

I am helping someone pick a Medicare plan, who can afford to spend ~10k per year on medical care in the worst-case scenario. A newbie question came up - is it possible to get financially ruined by someone with Medicare plan, and if so, under what cases?

I know Medicare does not cover Nursing home / Assisted living facilities.

Other than that, is there any other large costs one could possibly encounter?

If my understanding is correct, after looking at a variety of Medicare health advantage plans, there is a max out of pocket of ~$3500 for all non-drug charges, and when it comes to drugs, after ~$4500 out of pocket expenses, there are very minimal "catastrophic" drug charges. So, it would seem like, whether you have open heart surgery, prolonged cancer requiring chemo & radiation, stay in hospital for half a year, or any other kind of medical calamity, at most one would pay 3500+4500=8k per year... Am I missing some scenarios? (hmm.. maybe prolonged chemo is not covered actually?) What medical expenses could possibly exceed the above numbers aside from nursing-like facilities?
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Old 11-02-2010, 11:16 PM   #2
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Quote:
Originally Posted by smjsl View Post
I am helping someone pick a Medicare plan, who can afford to spend ~10k per year on medical care in the worst-case scenario. A newbie question came up - is it possible to get financially ruined by someone with Medicare plan, and if so, under what cases?

I know Medicare does not cover Nursing home / Assisted living facilities.

Other than that, is there any other large costs one could possibly encounter?

If my understanding is correct, after looking at a variety of Medicare health advantage plans, there is a max out of pocket of ~$3500 for all non-drug charges, and when it comes to drugs, after ~$4500 out of pocket expenses, there are very minimal "catastrophic" drug charges. So, it would seem like, whether you have open heart surgery, prolonged cancer requiring chemo & radiation, stay in hospital for half a year, or any other kind of medical calamity, at most one would pay 3500+4500=8k per year... Am I missing some scenarios? (hmm.. maybe prolonged chemo is not covered actually?) What medical expenses could possibly exceed the above numbers aside from nursing-like facilities?
Check out the max number of days on wikipeda for example. Severe illiness that drag on for over 60 days start costing a lot without a supplemental policy. So some form of medigap is needed see if one exists that has a high deductable the case you cite.
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Old 11-03-2010, 11:29 AM   #3
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We are looking mostly at Medicare advantage plans, which seem more cost effective than medicare + medigap policies. These plans include effectively medicare + medigap + drug coverages combined.

Under these plans, again if I understand their coverage correctly, hospital (non-drug) bills are covered at the maximum out-of-pocket of $2500 which is reached after first 8-9 days (for hospital+non-hospital it's ~$3500), and then it's covered 100% for at least 90-day hospital stay (or unlimited? not sure). Drugs maximums follow medicare guidelines for ~$4500 + cheap catastrophic coverage after that...
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