These plans are offered by private insurance companies and replace your Medicare coverage by the government. Part C, most commonly known as Medicare Advantage plans, are a combination of benefits in one package. Check out that article here: Medicare Gaps and How to Fill Them Other Medicare PRIVATE INSURANCE COMPANIES Part C We have a whole article on how to fill the various gaps in Medicare, including how to protect yourself against this unlimited 20% number. So, if you were to have a $100,000 claim, Medicare would cover $80,000 and you would be responsible for the remaining $20,000. Unlike your traditional health insurance coverage through an employer, as an example, under Medicare, there is no maximum on that 20%. The remaining 20% of those charges are your responsibility. Your Part B deductible is an annual deductible, meaning you are responsible for the first $203 before Medicare steps in and starts to cover expenses.Īfter you have met your Part B deductible, Medicare covers 80% of Medicare-approved charges under Part B. The Part B deductible is less complicated than the Part A deductible. Check out the income levels and cost adjustments here: Part B Premium Amounts Therapy – Physical, occupational, and chemotherapy are examples of the therapies covered under Part B.įor most people, Part B costs $148.50 per month for 2021.Ĭosts may be higher for those with higher incomes.Labs & X-rays – Your labs, x-rays, and tests are covered under Part B.This includes Emergency Room visits, observation services, outpatient clinic services, and same-day surgery. Outpatient care – This is care you receive when you haven’t been formally admitted to a hospital.Doctor services (inpatient/outpatient) – Any bills from your doctors themselves, not the facilities, would fall under Part B coverage.This would include the charges from your doctors, both inpatient and outpatient, your outpatient care, labs, tests, x-rays, and others listed below. Give us a call for more details around Part A coverage gaps and how to protect yourself against them. There are other gaps for which you would be responsible under Part A. The benefit period ends when you haven’t received any inpatient hospital care for 60 days in a row. The Part A benefit period begins the day you are admitted as an inpatient hospital stay. *2021 numbers – T hese amounts adjust each year $458 per month * – you (or your spouse) worked less than 30 quarters.$252 per month * – you (or your spouse) worked for 30-39 quarters.
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