Medicare Deductibles & Copayments
- Like most health insurance plans, Medicare has annual deductibles. Both parts of Medicare have their own deductibles, which is the amount you will need to spend before Medicare starts paying benefits. As of 2011, the deductible for Part A Medicare was $1,132 per year. Part B also has a deductible of $162.
- Original Medicare has specific copay amounts for hospital stays. If you use these benefits, you will have to pay the copay yourself and Medicare will offer benefits for the rest. The copay for hospital stays of 61 to 90 days in 2011 was $283 per day. The copay for hospital stays longer than 91 days is $566 per day. If you need skilled nursing facility care, you will need to pay $141.50 per day for 21 through 100 days of services.
- Medicare beneficiaries will generally have to pay a co-payment of 20 percent for most services covered under Part B. The co-pay applies even after you have met your yearly deductible. If you get your services as an outpatient at a hospital, you may also owe a co-payment to the hospital. Services that require the 20-percent copay include ambulance services, approved treatment from ambulatory surgical centers, cardiac rehabilitation, a limited amount of chiropractic services, all doctor services, self-management training for diabetics and diabetic supplies, health tests and screenings, foot treatment and dialysis services and supplies.
- If you are diagnosed with a terminal illness, you become eligible for hospice care during the last six months through Medicare Part A. Hospice care still requires co-pays, but they are less than 20 percent. In 2011, co-pays for symptom management and pain medication for hospice patients was only $5 per prescription. Inpatient respite care for hospice is 5 percent, and hospice care itself does not require any co-pay.
