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Know the limits of Medicare coverage

Today there was an article in The Herald in Everett, WA regarding Medicare and its limits that got me thinking.   Most people are ignorant of what exactly Medicare/Medicaid covers.  This is no surprise, for the rules change from time to time and most people think that the system covers them when they need it.

In the case covered in the paper today, they point out all of the fine nuances of medical care that make it just enough to make you want to pull out your hair.  In this case, the patient was not admitted to the hospital after a surgery, but instead was recommended for observation.  Medicare wouldn't pay for care while "under observation" and the Long Term Care Insurance policy that the lady had was set to begin paying after a 90-day elimination period, so the family was in a pickle. 

There are many reasons to have long term care insurance, and having a shorter elimination period is a nice luxury, but does of course push up premiums.  When you are trying to decide which policy you are interested in purchasing, you have to make priorities.  You can choose a lower waiting period, say 30 days, but your premiums will be pushed up fairly drastically.  On the flip side of the coin, when you DO need to use your policy, having that shorter elimination period will reward you greatly.  Imagine costs at $100/day (extremely conservative for most cases) and a 30 day elimination period saves you $6,000 over a 90-day elimination period.

The rule of thumb with Medicare right now is that something has got to change.  If not, the "social safety net" will be useless to most Americans with all of the fine print that makes coverage so hard to understand. 

 

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