Is Medicare Supplemental Insurance Worth It?

Dr. Dave opines again on Medicare supplemental insurance policies…………….

Hello again everyone!

By David Belk, M.D.

So, how much would a liver transplant cost someone who has Medicare, but no other health insurance coverage?

I often tell people who have Medicare that they don’t really need to buy extra healthcare coverage. When I say this, though, they always ask me: “What if I have a catastrophic medical illness? How much would it cost me?”

Okay, you want catastrophic, I’ll give you catastrophic.

Start with liver cancer that gets treated with chemotherapy, radiofrequency ablation therapy and then a liver transplant.

Add to that a post-operative complication requiring two more hospitalizations (after the transplant) for a total of 42 days in the hospital.

Then include all of the outpatient tests and doctors’ visits including the MRIs, ultrasounds, dozens of blood tests, postoperative care, etc…

I’ll even add 61 sessions of psychotherapy for an unrelated emotional trauma and 16 sessions of physical therapy for an unrelated injury.

Is that catastrophic enough?

All of this happened to a patient of mine in 2016 and 2017. She’s doing quite well now, but during those two years she received more medical care than most people will receive in a lifetime.

How much did all of this cost?

Well, the billing charges for all 330 billable services she endured over that two-year period exceeded $1 million. But those were just billing charges and, as you probably know by now, those charges are just works of fiction.

The total amount she would have paid if she had only Medicare was $15,480! That’s the grand total of all of the deductibles and co-insurance she would have owed for all 330 medical services she received.

That’s a lot of money, but not nearly as much as most people would have guessed for all of that medical care.

The point of all of this is that this person and her husband together pay $359 a month for a supplemental insurance policy that covered her $15,480 bill. That’s about $4,300 a year in premiums, and that amount increases every year for them.

So the amount they pay in premiums is roughly enough to pay for a new liver for one of them about every four years. Most people will never need a new liver, even once.

So, are these policies worth their price? After going through all of these bills, I’m still not recommending them.

You can listen to a radio interview I gave for Dave Ross on the Seattle Morning News last December on this subject here:

https://www.stitcher.com/podcast/seattles-morning-news-with-dave-ross-2/e/57549557?autoplay=true

The webpage I wrote discussing this case more completely is here:

https://truecostofhealthcare.org/liver-transplant-case-study/

And the itemized list of all 330 billable services my patient endured, as well as the charge and payment for each of those services is here:

http://truecostofhealthcare.org/liver-transplant-billing/

As always, feel free to write me with any questions, comments or just to correct my typos.

David Belk MD
Internal Medicine
truecostofhealthcare.org

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