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Why You May Need More than Medicare
What Medicare Pays
Medicare typically pays only 80% of the medical services it covers. That leaves 20% - plus copays - for you to pay.
- 20% of even a routine procedure can add up in a big way
- Even with Medicare coverage, a single day in the hospital can cost you more than $1,000.
- Under Medicare, you're responsible for deductibles and copays, both of which go up every year
Imagine how an extended stay would begin to add up. A two-week hospital stay could cost you more than $14,000.
How Medigap Can Help
Medigap plans fill in gaps left by Medicare - covering your deductibles, copays, and/or coinsurance. Some Medigap plans also cover medical services that aren't covered by original Medicare, like:
- Extended hospital stays
- Outpatient services
- Tests
- Emergency care overseas
| What Medicare Does Not Pay |
|---|
Part A – Hospital Services |
$1,068 inpatient hospital deductible |
$267 a day copayment for hospital days 61-90 |
$534 a day copayment for hospital days 91-150 (Lifetime Reserve Days) |
100% of Medicare-allowable expenses for additional 365 days after Medicare hospital benefits stop completely |
First 3 pints of blood |
$133.50 a day for days 21-100 in a skilled nursing facility |
Part B – Outpatient Services |
$135 Part B deductible |
20% of outpatient charges |
100% of charges over Medicare's allowed amount |
Other Expenses |
Medically necessary emergency care received in a foreign country ($250 deductible; $50,000 lifetime maximum) |
| Medicare raises its deductibles and copays every year. And every year, Medigap coverage picks them up. |
Plan Resources
Additional Information
- Enrolling in a Part D plan does not replace your need for Medicare or your current Medigap plan.
- Medigap plans are offered through our affiliate, CareFirst BlueCross BlueShield.
- Sign up when you become eligible or you may have to pay a penalty.
- For more information, visit Medicare.gov.
We administer Maryland's SPDAP program
Find out what it is and if you're eligible.