Missing Medigap Hospital Coverage

Waynek

New Member
8
Ohio
This is a follow up to my question on Lifetime Reserve days. If you have a Medigap policy, you gain an additional 365 Lifetime Reserve days. Once those are used up, you have zero coverage for hospital days beyond 90 days. I know that the odds of needing it are very low but the purpose of insurance is to protect you from large losses from unlikely events. My existing health insurance has no limit on hospital stays. And I believe that's the case for Medicare Advantage plans as well.

I find the missing hospital coverage troubling, and it's the one thing that has me hesitating about a supplement. One way of looking at is that it's just one of a number of things missing from Medicare coverage. If you ever get in that situation, maybe you could get moved out of the hospital for 60 days to get a new benefit period which gets you 90 more days of Medicare hospital coverage.

I guess another way of looking at is that if you're in the hospital that long, you're probably about done for, anyway.

I'd appreciate any thoughts on this missing coverage and especially
whether there are any options for covering it. I've done a lot of reading and searching but have failed to find any detailed discussion of this.

Wayne
 
Wayne-
Using all 365 lifetime days in the hospital is incredibly rare. You must be in acute care during that time. It is highly unlikely that you will hit that mark.

Typically what happens is, you stay in a hospital for a week or two, or even a month if you are really sick, then you are transferred to rehabilitative care. I would be more worried about your skilled nursing days, rather than hospital days. You have 100 days of progression that Medicare will cover. This is getting better time. If you stop getting better, you could be on the hook for the full cost of care in rehab. I would be having a conversation with the guys in the Long Term Care forum. . .
 
Wayne-
Using all 365 lifetime days in the hospital is incredibly rare. You must be in acute care during that time. It is highly unlikely that you will hit that mark.

Typically what happens is, you stay in a hospital for a week or two, or even a month if you are really sick, then you are transferred to rehabilitative care. I would be more worried about your skilled nursing days, rather than hospital days. You have 100 days of progression that Medicare will cover. This is getting better time. If you stop getting better, you could be on the hook for the full cost of care in rehab. I would be having a conversation with the guys in the Long Term Care forum. . .

Good advice. I know this blends into long term care issues but LTC doesn't pay for medical treatments. I know it's incredibly rare that it would be needed. If that's true, why don't they just cover it so we don't have to worry about it (rhetorical question)?
 
I have yet to see or hear of it. 36 years selling Medicare supplements. I'm beginning to think I will see Bigfoot first.

Yes, I said it's extremely unlikely to occur. But I thought insurance was to protect you from rare, catastrophic losses? If my home is flattened by a meteor, I'm covered (I think!).

I don't understand why Medigap plans trumpet their coverage of routine expenses but ignore a catastrophic risk (a risk that is not ignored by regular health insurance or Medicare Advantage plans).
 
I have yet to see or hear of it. 36 years selling Medicare supplements. I'm beginning to think I will see Bigfoot first.

But in 36 years you've only sold 43 supps and 6 of them were moving your own client to another carrier.

Get a bit more experience sonny boy.

Rick
 
Back
Top