Since a large majority of our clients are over the age of 65 or disabled and receiving Social Security, those clients also receive Medicare benefits. Medicare does not cover long term care so as elder law attorneys we don’t spend much time addressing Medicare questions and problems.
However, I do get questions from clients who are turning 65 about what to choose when it comes to sufficient coverage. There are gaps in Medicare coverage so a comprehensive supplemental or “Medigap” policy is important to fill those gaps. We refer these questions to knowledgeable insurance professionals who focus on the Medicare supplement market and are very adept at finding the right policy for clients.
A call I received not too long ago highlights the importance of these supplemental policies. Mary called because her husband John, age 75, was in the hospital. He had a heart attack which led to further complications caused by diabetes. The result is that he has been in the hospital for an extended period of time. Mary told me that he has been hospitalized for 4 months now and is within 30 days of using up his Medicare lifetime reserve days.
Mary and John have more than $30,000 of out of pocket costs for his hospitalization and counting. That’s attributable to Medicare deductible and co-pays for which John is responsible. Of even greater concern is that in another 30 days they are faced with no coverage for John’s hospitalization if he doesn’t make enough improvement to be able to be discharged from the hospital.
How could that be? Doesn’t Medicare cover hospitalization under Part A? It does but there are many gaps in coverage. That’s where Medigap insurance comes into the conversation. The problem is that John neglected to purchase a Medigap policy.
I’ll explain more next week.