Originally Posted by MichealKnight
Hello, I am tinkering with future plans, i.e retirement.
My question is.... *today*....if you are on Medicare....can you please say what your total "out of pocket" expenses are for health care? Be it by month, or for a whole year?
Thank you in advance....
I will give you my numbers but first you need to assess if you are/will be a light, moderate or heavy user of medical (Doctor, Hospital, Durable Medical Equipment- DME like CPAP, Constant Glucose Monitoring (CGM), etc. Then you also need to assess if you are/will be a light, moderate or heavy user of prescription drugs. These assessments will tell you how much insurance you need to buy.
My current monthly costs for 2 people are $946.61 per month for Medicare Part B, a Medicare Advantage plan with an annual $600 per person out of pocket (OOP) limit, a great prescription drug plan, dental and vision.
My copays (up to the $600 per year OOP limit) are: PCP doc $5, specialist doc $10, Hospital ER $65, Hospital in-patient $100, ambulance $50, DME $20, labs $0, and radiology tests $20. I have hit my $600 OOP limit for the last 4 years, including 2020 by June.
Prescription drugs copays: Generic - the lower of $10 or actual cost for each 90 day supply and Name brand - $40 for each 90 day supply.
I take 4 maintenance Name brand drugs each with an annual cost over $6,000, with an annual OOP of $160 each. I also take 7 Generic maintenance drugs with an annual OOP of $200 and other Generics at an annual cost of $65.
My savings/break even is simple for me and DW: annual insurance cost $11,359.32 ($946.61 x 12), $600 OOP limit for me, $300 OOP for DW, and $1,425 copays for DW and me for prescription drugs for an annual total of $13,684.32. My 4 Brand name drugs would cost $24,000 per year alone, not counting the tens of thousands annual cost for doctors and hospitals. That should help in understanding why $946.61 in monthly insurance premiums are a very good deal for DW and me.
Good luck with your research!