|
Benefit |
Medicare Pays |
You Pay |
Hospitalization
Semi-private room, general nursing, misc.services.
|
First 60 days |
All but $840 |
$840 |
| 61st to 90th day |
All but $210 |
$210 per day |
| 91st to 150th day |
All but $420 per day |
$420 per day |
| Beyond 150 days |
Nothing |
All charges |
Skilled Nursing Facility
Care After hospital stay
|
First 20 days |
100% if approved |
Nothing |
| 21st to 100th day |
All but $105 per stay |
$105 per stay |
| Beyond 100 days |
Nothing |
All charges |
Home Health Care Medically
necessary skilled-care, therapy |
Part-time care |
100% if approved |
Nothing |
Hospice Care For
the terminally ill |
As long as doctor certifies need |
All but limited costs for drugs & respite
care |
Limited costs for drugs & respite care
|
| Blood |
Blood |
All but first three pints |
First three pints |
|
| |
Benefit |
Medicare Pays |
You Pay |
Medical Expenses
Physician services & medical supplies |
Medical services in and out of the hospital
|
80% if approved
(after deductible*) |
20% if approved
(after deductible*)
plus excess charges |
| Clinical Laboratory |
Diagnostic tests |
100% if approved |
Nothing |
Home Health Care Medically
necessary skilled-care, therapy |
Part-time care |
100% if approved |
Nothing |
| Durable Medical Equipment (DME)
|
Prescribed by doctor for use in your home
|
80% if approved
(after deductible*) |
20% if approved
(after deductible*)
plus excess charges |
| Outpatient Hospital Treatment
|
Unlimited if medically necessary |
A fee schedule amount
(after deductible*) |
Coinsurance or fixed copayment amount, which
varies according to the service (after deductible*) |
| Blood |
Blood |
All but first three pints |
First three pints |
* A single,
yearly $100 deductible covers all Part B services.
|