| When you are hospitilized for: | ||
| 1-60 Days | Most confinement costs after the required Medicare Deductible | $1,024.00 Deductible |
| 61-90 Days | All eligible expenses after the patient pays a per day co-payment | $256 a day co-payment as much as $7,680 |
| 91-150 days | All eligible expenses, after patient pays a per-day co-payment. (These are Lifetime Reserve Days which may never be used again.) | $512 a day co-payment as much as $30,720 |
| 151 days or more | Nothing | You pay all costs |
| Skilled Nursing Confinement: When you are hospitalized for at least 3 days and enter a Medicare approved skilled nursing facility within 30 days after hospital discharge and are receiving skilled nursing care | All eligible expenses for the first 20 days; then all eligible expenses for 21-100, after patient pays a per day copayment | After 20 days, $128.00 a day co-payment as much as $10,240 |
| On expenses incurred for: | ||
| Medical Expenses Physical services, inpatient, outpatient, medical/surgical services, physical/speech therapy, diagnostic tests |
80% of approved amount | 20 % of approved amount |
| Clinical Laboratory Services blood tests, urinalysis |
Generally 100% of approved amount | Nothing for services |
| Home Health Care Part-time of intermittent skilled care, home health aide services, durable medical supplies and other services |
100% of approved amount for durable medical equipment | Nothing for services; 20 % of approved amount for durable medical equipment |
| Outpatient Hospital Treatment Services for the diagnosis or treatment of an illness or injury |
Medicare payment to hospital based on hospital costs | 20% of billed amount |
| Blood | After first 3 pints of blood, 80% of approved amount | First 3 pints plus 20% of approved amount for additional pints |
| On all Medicare-covered expenses, a doctor or other health care provider may agree to accept Medicare "assignment". This means the patient will not be required to pay any expense in excess of Medicare's "approved" charge. The patent pays only 20% of the "approved" charge not paid by Medicare. |
| Physicians who do not accept assignment of a Medicare claim are limited as to the amount they can charge for covered services. |
| *If your income is above $82,000 (single) or $164,000 (married couple), then your Medicare Part B premium may be higher that $96.40 per month. |