A recent anonymously written Op-ed piece Anonymous’ vs. Trump: Resistance From Within presents a Whitehouse staff trying to save the country from Donald Trump's worst behavior. I have an experience from my life I offer here as an analogy.
My father was in his early eighties when he had some traffic accidents in a short period of time. The first occurred in a hospital parking lot when he inexplicably drove his car on to the sidewalk, taking out a bench and damaging is front fender in the process. His explanation of the incident was that the rubber pad of the brake came off somehow, and his foot slipped to the accelerator. I inspected the brake pedal and could not believe this story at all. Soon after, the same type of incident occurred, this time at a facility housing my invalid sister. In both cases, no one was hurt. Prior to these 'accidents', my father called to tell me he was lost en route to our house. It was a route he had taken dozens of times, involving two turns. Another time when he was a passenger, he insisted we were on the wrong road to Fullerton. When we persisted and arrived at our destination, he joked, 'They must have moved Fullerton.' We coached him to consider stopping his driving, but he insisted that he has always been a fine driver.
The time came for his driver's license to be renewed, and thankfully, the occasion required a driver's test. The DMV tester failed him on multiple tasks. We were relieved because we were clearly fearful that the next 'accident' could seriously injure or kill someone. In retrospect, we should have made sure that he could not drive by taking away the keys to the car.
I am confident there are people across the country who have faced a nearly identical situation with respect to someone who needs to have the keys to the car taken from them. Insofar as the office of the President affects the lives of millions of people every day and the President's has repeatedly demonstrated that his 'driving' is 'off the rails', it is the responsibility of those closest to him to take away his keys.
- $1,340 ($1,364 for 2019)
deductible for eachbenefit period . - Days 1–60: $0
coinsurance for each benefit period. - Days 61–90: $335 ($341 for 2019) coinsurance per day of each benefit period.
- Days 91 and beyond: $670 ($682 for 2019) coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).
- Beyond
lifetime reserve days : all costs.
Clearly, in any given year, my costs could range from zero to:
$1,364 + ($341 x 30) + ($670 x 60) = $(1364+10230+40200)= $51,794.
However, the above extreme would exhaust my lifetime benefits (I think). Given that most years will not feature hospital visits, and given that we have savings and home equity that could cover a catastrophic illness, supplemental insurance is not required. However, it is worth investigating what additional coverage we could get at what cost. For example, if a $1,200/year premium would cover most of the potential $50k out-of-pocket costs for an extreme year plus the 'beyond lifetime reserve days,' the cost could be rationalized. Taking this further, in the extreme case over the next 30 years, we would have paid ($1,200 x 30 =) $36,000 to get no benefits if we go into the hospital for less than 60 days. On the other extreme, we experience two trips (one for each of us) that goes 90 days, for a total of over $100k.
In all of my experience, including people I have known, 90 days in the hospital is extremely rare. It is almost unknown I would say. My conclusion it is unwise to insure for costs that exceed 90 days in the hospital simply because the risk of the occurrence is small, and out capacity to cover the most likely of the least likely is still very good.
Coverage for a more likely (but still, low risk) situation is a stay in a Skilled nursing facility. Again, one must assess the instances that would exceed 100 days, because up to 20 days is no cost, and for the next 80 days, the cost is $10k. Again, in my experience, such an occurrence is extremely rare and unlikely to justify the cost of monthly premiums.
Your costs in Original Medicare
You pay:
- Days 1–20: $0 for each
benefit period . - Days 21–100: $167.50 ($170.50 for 2019)
coinsurance per day of each benefit period. - Days 101 and beyond: all costs.
Last but not least is the kind of care my mother had in the last 20 months of her life. This is a nursing home, and it cost on the order of $4k per month. It is unclear to me how this was paid. Was it the private health insurance, Social Security, or a combination? How it is that I do not know this is an amazing lack of attention. However, if we can assume no health insurance coverage for the cost, we can use our estimated Social Security payment of around $3,600 as a base for such care. This leaves a small amount to cover the remaining part, and this would surely come from our home equity plus savings.
Getting back to the topic, I am becoming comfortable with the idea that getting extra coverage outside of Medicare is unnecessary and unlikely to be of value. In addition, the major emphasis of advertising for supplemental insurance is for prescription drug coverage, a topic of zero interest to me. Pursuing insurance to cover incidents outside of what is covered by Medicare is akin to worrying about other exceedingly rare occurrences.