If Medicare is a roof over your home, you would notice some leaks from health care costs. While Medicare is a pretty good roof, there is a gaping hole that allows prescription drug costs to flood your basement. There are a variety of insurance products and programs to fix almost all the leaks so your house stays dry inside.
Drug Costs Flood Your Medicare Basement
At a minimum you to need to add the Part D prescription drug plan to your Medicare roof. Even if you don’t use prescription medications, you might in the future. There is a potential for a large storm to drop lots of drug costs into your house. The Part D drug plan won’t stop all of the medication costs, but they are pretty good at limiting the rain and swamping your carpet in your family room.
Medicare Supplement to Repair the Medicare Roof Leaks
Another layer to divert the Medicare health care cost leaks is with a Medicare Supplement plan. The very highest level of Medicare Supplement – Plan G for individual turning 65 after 2020 – will only let the Part B outpatient deductible seep through the roof. With a large cup or bowl, you should be able to capture the deductible amount of $226 for 2023. Original Medicare, coupled with a Supplement and Part D drug plan should keep you relatively dry. However, the Medicare Supplement plans can be a roof repair too expensive for some people.
Medicare Advantage Plan Divert Most Costs to Gutters and Downspouts
Medicare Advantage plans, that cannot be paired with a Medicare Supplement plan, is another way to divert much of the storm of health care costs to the gutters and downspouts. The Medicare Advantage plans usually have the Part D drug plan embedded within the total package. There will still be some leaks from copayments and coinsurance with the Medicare Advantage plans. The monthly premiums can be very small to nonexistent, and the drug costs can be less than with a stand-alone Part D plan.
Medicare Savings Program Health Care Cost Roof Repair
For some people, even a light sprinkle of health care cost rain can overwhelm their finances. For individuals with very low incomes there is the Medicare Savings Program. At the very highest level of benefit (Dual eligible Medicare-Medicaid) all of the health care costs will be covered by Medicaid, including the Part B monthly premium. There is also the Social Security Low Income Subsidy that can capture much of the financial leaks from prescription drug medication costs.
The Medicare Savings Program, administered by Medi-Cal in California, has separate income limits from the Social Security Low Income Subsidy. Even though you may not qualify for the Medicare Savings Program, you may qualify for extra help with the Social Security Low Income Subsidy for prescription medication costs because it has higher income limits. When in doubt, always apply for both programs. Your leaky roof might get completely restored.
