Plan A - Medicare Part A - Hospital Services - Per Benefit Period
| Services
/ Part A |
In
2012 Medicare Pays |
Plan
A Pays |
You
Pay |
| HOSPITALIZATION* Semiprivate room and board, general nursing and miscellaneous services and supplies -First 60 days |
All
but $1156.00 |
$0 |
$1156.00
(Part A Deductible |
| -61st through 90th
day |
All
but $289.00 a day |
$289.00
a day |
$0 |
| -91st day and after -While using 60 lifetime reserve days |
All
but $578.00 a day |
$578.00
a day |
$0 |
| -Once lifetime
reserve days are used: -Additional 365 days |
$0 |
100% of Medicare Eligible Expenses | All
costs |
| -Beyond the
additional 365 days |
$0 |
$0 |
$0 |
| SKILLED NURSING
FACILITY CARE* You must meet Medicare's requirements, including having been in a hospital for at least 3 days and entered a Medicare approved facility within 30 days after leaving the hospital -First 20 days |
All
approved amounts |
$0 |
$0 |
| -21st day through
100th day |
All
but $144.50 a day |
$0 |
$144.50
a day |
| -101st day and
after |
$0 |
$0 |
All costs |
| BLOOD -First 3 Pints |
$0 |
3
pints |
$0 |
| -Additional amounts |
100% |
$0 |
$0 |
| HOSPICE CARE Available as long as your doctor certifies you are terminally ill and you elect to receive these services |
All
but very limited coinsurance for outpatient drugs and inpatient respite
care |
$0 |
Balance |
Plan A - Medicare Part B - Medical Services - Per Calendar Year
| Services
/ Part B |
In
2012 Medicare Pays |
Plan
A Pays |
You
Pay |
| MEDICAL EXPENSES IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT: such as physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment -First $140.00 of Medicare Approved Amounts** |
$0 |
$0 |
$140.00
(Part B Deductible |
| -Remainder of
Medicare Approved Amounts (after the Part B
Deductible) |
Generally
80% |
Generally
20% |
$0 |
| -Part B Excess
Charges (above Medicare Approved Amounts) |
$0 | $0 |
All
costs |
| BLOOD -First 3 pints |
$0 |
All
costs |
$0 |
| -Next $140.00 of
Medicare Approved Amounts** |
$0 |
$0 |
$140.00
(Part B Deductible) |
| -Remainder of Medicare Approved Amounts |
Generally
80% |
Generally
20% |
$0 |
| CLINICAL LABORATORY SERVICES--BLOOD TESTS FOR DIAGNOSTIC SERVICES |
100% |
$0 |
$0 |
Part A & B
| Parts
A & B |
In
2012 Medicare Pays |
Plan
A Pays |
You
Pay |
| HOME
HEALTH CARE - MEDICARE APPROVED SERVICES Medically necessary skilled care services and medical supplies |
100%
while approved |
$0 |
All
charges after Medicare |
| Durable medical
equipment -First $140.00 of Medicare Approved Amounts** |
$0 |
$0 |
$140.00
(Part B Deductible) |
| --Remainder of
Medicare Approved Amounts |
80% | 20% |
$0 |
Plan A, Plan B, Plan C, Plan D, Plan F, Plan G, Plan K, Plan M, Plan N
*A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
**Once you have been billed $140 of Medicare Approved amounts for covered services (which are noted with an asterisk), your Part B Deductible will have been met for the calendar year.
Brindle Insurance Group is not associated with Medicare, Social Security or any other Government Agency.
The information on this site is an overview for generalization only. For exact definition of terms, benefits, exceptions and exclusions as well as any waiting periods, you must see the policy itself.
The Policy contained herein may have some Limitations and Exclusions.
*A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.
**Once you have been billed $140 of Medicare Approved amounts for covered services (which are noted with an asterisk), your Part B Deductible will have been met for the calendar year.
Brindle Insurance Group is not associated with Medicare, Social Security or any other Government Agency.
The information on this site is an overview for generalization only. For exact definition of terms, benefits, exceptions and exclusions as well as any waiting periods, you must see the policy itself.
The Policy contained herein may have some Limitations and Exclusions.
