08/31/2026
To see the potential impact and why you want to make sure you have a Medicare plan that will work for you, you really must do the math. I'll break it down for you:
For an inpatient hospital stay that $1,736 deductible is not a calendar year deductible, it could happen several of times a year.
Then after 60 days in the hospital there are the daily co-payments of $434 per day which can last up to 30 days... that could total $13,020 per confinement. Still in the hospital... For days 91 – 150 (these are “Lifetime Reserve Days” and can only be used once) the patient’s co-payment is $868 per day that could total $52,280.
Finally after the 150th day Medicare pays nothing.
In a skilled nursing facility for days 21 – 100 the co-payment of $217 per day could total $17,360. Then after the 100th day Medicare pays nothing. This why many people have Long-Term Care insurance.
Also it's important to note that Medicare pays 80% of it’s “approved charges”, the patient is responsible for the other 20% as well as any excess charge over the approved charges.
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Tim Vendt is an independent insurance agent in MO (Lic. #316525) & AR (Lic. #7683202).
