Hospital Insurance

• Most people don't pay a monthly premium
• Inpatient hospital care
• Inpatient mental health care
• Skilled nursing services
• Hospice care
• Some blood transfusions
• $1,632 deductible/admission for a hospital stay of fewer than 60 days
• Stays of more than 60 days require additional daily copays 
• Multiple stays may mean multiple deductibles
• Visit any qualified hospital in the U.S. that accepts new Medicare patients
• Hospital care outside the U.S. isn't usually covered

Doctor & Outpatient Visits

• $174.70 monthly premium (may be higher based on income)
• Physician services
• Outpatient hospital services
• Ambulance
• Outpatient mental health
• Laboratory services
• Durable medical equipment (wheelchairs, oxygen, etc.)
• Outpatient physical, occupational therapy
• Some preventive care
• You can get care throughout the U.S., but generally not outside the country
• Participating physicians who accept Medicare patients
• $240 annual deductible for 2024
• Medicare pays 80%, you pay 20% of Medicare-approved cost
• No Maximum-Out-of-Pocket (MOOP)
• No RX Coverage

• Designed to cover what Medicare Parts A & B doesn't – such as deductibles, co-payments, and co-insurance.
• Plans are named A, B, C, D, F, G, K, L, M, N and HDF (except WI, MN, MA).
• Pay-Upfront Type of Plan

Pros

• If plan is put together correctly you will have little to no out-of-pocket costs for medical care.
• Goes with you anywhere in the U.S.
• No networks.
• Guaranteed renewable as long as you pay your premium on time and not made any material misrepresentation on your application for insurance.

Cons

• Premium at age 65 starts at $160+ per month. The more comprehensive coverage, the higher the premium.
• In most cases, premiums are based on gender, ZIP code and age.
• Average increase: 6-7%/year.
• Premiums nearly double every 10 years.
• No RX Coverages included

• Helps with cost of outpatient prescription drugs
• Only offered through private insurance companies
• Most states have 25-30 plans
• Each plan has a list of drugs it covers (formulary)
• Make sure your drugs are covered before you enroll in the plan. The list of 
  drugs changes yearly.
• Coverage is not automatic.
• Penalties may apply if you enroll late (1% per month accumulating).
• Average cost for Part D is $35-45 per month