Do you have to run through all your savings before you qualify for medicare? How much does private insurance cost for a 70 year old? I would assume $400+ a month for high deductible insurance, so does a person have to pay that until they are broke then they get medicare? I’m not sure how it works.
Part B (which covers outpatient services) is optional.
As an insurance biller (I see Medicare secondary claims all the time), I strongly advise you to get Part B coverage.
Thats probably a good idea. I like to dance the charleston with my flapper (she has gams like a racehorse, but a real flat tire in the sack if you’re on the trolley) and my hip has been acting up, so outpatient services may be for me,
In case you need incentive, here’s an example:
Patient chose not to have Part B coverage and has supplemental coverage with a major insurance company. According to the policy, because Part B was not chosen, but was available, they’ll only pay 20% of allowed charges (pray the insurance company has a contract with the hospital you’re going to like in this case).
The patient racked up $18,000 in outpatient radiation therapy. Our contracted rate was $8775. Thus, the insurance company paid $1755 and the patient will have to pay $7020!!
But does a person need to use all their personal savings before they qualify for medicare?
I think you’re automatically qualified when you hit 65.
Here’s the premium info and there is no mention of the value of your assets. I recently dealt with an apperently wealthy patient who has Medicare.
You may be thinking of Medicaid, which is a state-based program. There are limits with this.
If you think you may have a lot of medical problems after you hit 65, get some GOOD secondary insurance. This will usually pay your deductible.
Oh yeah, if you are working and can be covered by an employer’s insurance, then Medicare won’t cover you.
In general, not strictly legal, terms (and making some really broad generalizations):
Medicare is an extension of Social Security: everyone gets it when they get old enough;
Medicaid is Federally backed, state administered medical insurance for poor folks.
The “exhaust your resources” requirement generally comes into play when an elderly person needs full-time residential care, covered by Medicaid.
Medicare will pay whatever expenses it is set up to handle, regardless of one’s personal wealth. Bob Hope and Frank Sinatra could have been using Medicare funds right up until they died. (I have no idea whether they did or not; I am only addressing their eligibility.)
And strangely enough, if your company has an employer-sponsored health plan but also has less than 20 employees, you can NOT be on the employer’s health plan once you become eligible because of your age for Medicare. It doesn’t matter if the company wants you on the plan or if you pay the whole premium yourself. If the company has less than 20 employees, you MUST go on Medicare as your primary provider and you or the company can get a secondary (“Medex”) policy to cover whatever Medicare won’t cover. Or you can choose not to go on Medicare but the employer’s insurance will no longer cover you.
To the OP: you can be a zillionaire and still be on Medicare. It has nothing to do with your assets. My boss falls into the situation described just above and even though he is a millionaire many hundreds of times over, he must use Medicare as his primary insurer because of the size of our company. He would have much preferred to stick with Blue Cross but he has no choice in the matter.
Medicaid pays for nursing home care. You have to be broke but your family doesn’t.
There’s something like a three-year look back provision. That is, if you do it properly, you can transfer assets(and perhaps income) essentially to a family member like a child and the family can keep the money and have the government pay the bills. See appropriate tax/estate planning advice.
Medicare: see above.
Medicaid: will pay toward nursing home care, etc, but with rules. If you have more than so much money, they let you pay your own. The taxpayer doesn’t subsidize millionaires in these cases.
Medicaid is state-by-state. This information is from my memory, and even if it is correct, it may not apply to your state.
For a person with assets, they will not provide money till the assets go so low, with rules. Say a person has a $300,000 house (paid off) and $200,000 in savings and investments. And say the person can’t live alone any more, they need help getting three meals cooked and other personal care. If they go into a nursing home, the $200,000 starts going down pretty fast. Now if their spouse lives at home, or if they intend to return home some day (say they have a broken hip, or other diagnosis that has hope for return), they can keep the house, otherwise it counts as a spendable asset.
So there are considerations. They could live at home and hire a live-in attendant, if that works for them. They may be more comfortable, and it’s about as expensive as a facility. (Nursing homes are now called ‘skilled care facilities’.)
When they get down to $X in assets, they can turn Medicaid on, but it may only pay for a cheaper s.c.f. Then they can use their $X to stay in a better s.c.f., or the family can chip in.
The period before Medicaid kicks in, it’s called ‘spending down’. The person may really want to leave their money to their family, and they can make certain gifts, but there are rules. They can use their money other ways.
All this requires decisions for the person and the family, based on good information (they want advice from experts on the rules and possibilities), and based on serious matters such as the person’s life expectancy, and what they want to happen after their death, as well as before.