My parents, ages 90 and 91, can no longer afford their Medicare Supplement Plan F and do not qualify for Medicaid. What happens if they cannot pay the 20% not covered by Medicare after cancelling the supplement?
Answered by 9 licensed agents
Going without a Medicare supplement can get risky fast because Original Medicare has no cap on the 20% they leave behind. One hospital stay, surgery, or ongoing treatment can create bills that are hard to recover from at their age. Before cancelling Plan F, it’s worth checking whether they could switch to a lower-cost supplement or even another company offering the same coverage for less. A Medicare Advantage plan may also be worth looking at since those plans are required to have a yearly max out-of-pocket limit.
Unfortunately, they may be faced with a lot of debt. You may want to look at a Medicare Advantage Plan that has a low Max Out Of Pocket. Traditional Medicare does not have a Max Out of Pocket.
This is a common question. They can get on a medicare advantage. But unfortunately Medicare Supplements go up every year.
Some hospitals also offer financial help but if they does qualify for medicaid I dont know if they would for that either. It is tough to say without sitting down and going over there drs, medications.
Without a supplement, there is no 'cap' or 'out-of-pocket maximum' on what your parents might owe. A single major surgery or hospital stay could result in thousands of dollars in personal liability. If the 20% remains unpaid, healthcare providers may eventually turn the debt over to collection agencies. To avoid this, it is often better to switch them to a Medicare Advantage (Part C) plan or a cheaper Supplement Plan N, which can significantly lower monthly premiums while still providing a safety net for that 20% gap.
there are a few options so it would take a deep dive into your parents situation. This is a difficult question to answer without a thorough interview.
However, remember that Medicare still pays first. This means Part A and B pays and the 20% is based on the Medicare allowed amount.
Also, there may be a possibility to 'downgrade" their Plan F to a less expensive plan, however, certain carriers have implemented changes to the ability to do this so it would depend on the carrier they currently have.
And lastly, there is always a Medicare Advantage plan as an option during the Annual Election Period.
First off the only difference between Plan F and Plan G is that plan F pays the part b deductible which is only $283 this year and often the premium is much higher. Some states have a birthday rule which then can move from a like to like plan or a like to less which in this case from Plan F to Plan G 60 days around their birthday. I recommend contacting a local agent to talk about options. If they move during AEP to a MAPD plan then then need to consider the Max out of pocket they may pay and that they will be confined to a network either in a PPO or HMO
At ages 90 and 91, it may make sense to consider moving to a Medicare Advantage Prescription Drug (MAPD) plan if their Medicare Supplement premiums have become unaffordable. Unlike Original Medicare alone, MAPD plans include an annual out-of-pocket maximum, which can help provide more predictable healthcare costs and limit financial exposure from the 20% coinsurance under Part B.
