If you're like many Medicare beneficiaries, you're concerned about Medicare out-of-pocket costs.
Out-of-pocket Medicare costs include deductibles, co-insurance, co-payments, and excess charges — which can add up to thousands of dollars a year.
Below are 5 health care costs uncovered by Medicare and how a Medicare Supplement insurance policy can help you avoid paying them.
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1. Deductibles
There are deductibles for Medicare Parts A and B that you must meet before coverage kicks in:
- $1,632 Part A deductible per benefit period in 2024
- $240 Part B annual deductible in 2024
9 of the 10 standardized Medigap plan options include some coverage for the Part A deductible. Only Medigap Plans C and F cover the Part B deductible.
Important: Plan F and Plan C are not available to beneficiaries who became eligible for Medicare on or after January 1, 2020.
2. Co-insurance and co-payments
Co-insurance and co-payments are fixed percentages or dollar amounts that you must pay out of pocket in order to get a medical service covered. You may have to pay co-insurance and co-payments for several Part A and Part B services. Here are a few:
Part A hospital care
You may have to pay the following in 2024 to use your Part A hospital care coverage:
- $408 per day for days 61-90 in each benefit period
- $816 per day for days 91+ in each benefit period (lifetime reserve days available)
- All costs for days 91+ in each benefit period (no lifetime reserve days available)
All of the nationally standardized Medigap plans include coverage for the Part A hospital care co-insurance.
Medicare Part B services
You have to pay co-insurance to get routine medical care covered through Medicare Part B.
In 2024, you must pay 20% of the Medicare-approved amount for most covered medical services. So if a procedure covered by Part B costs $1,000, you may have to pay $200 out of pocket.
All of the nationally standardized Medigap plans include some coverage for this cost.
Part A skilled nursing care
You may have to pay the following in 2024 to use your Part A skilled nursing care coverage:
- $204 per day for days 21-100 in each benefit period
- All costs for days 101+ in each benefit period
Medigap Plans C, D, F, G, M, and N provide full coverage for the Part A skilled nursing care co-insurance. Plan K and Plan L provide partial coverage.
3. First 3 pints of blood
If you need a blood transfusion, Medicare covers the cost only for the 4th pint and beyond.
You may need to pay the entire cost of the first 3 pints of blood for a transfusion.
All of the nationally standardized Medigap plans provide full or partial coverage for the cost of the first 3 pints of blood.
4. Excess charges
If your medical provider or facility does not accept Medicare assignment, you may face excess charges.
You may have to pay up to 15% of the Medicare-approved amount for a service in 2024 if your doctor does not accept Medicare assignment.
Medigap Plans F and G provide full coverage for excess charges.
5. Foreign travel emergency
Medicare only covers foreign emergency health care in a small set of rare situations.
You may have to pay all costs for any non-approved emergency care outside of the United States.
Medigap Plans C, D, F, G, M, and N pay for 80% of the cost of certain medically necessary foreign travel emergency care.
