Medicare Policies

We bill Medicare for inpatient and outpatient services. Supplemental insurance will also be billed at the patient's request if information is provided. Patients are responsible for any charges not covered by Medicare and/or supplemental insurance.

Medicare Deductible and Coinsurance Amounts for 2016:

Part A Inpatient Deductible: (pays for inpatient hospital, skilled nursing facility, and some home health care)

For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2016 = $1,288) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days. For each benefit period you pay:

  • Days 1 - 60: $1,288.00
  • Days 61 - 90: $322.00 per day
  • Days 91 - 150: $644.00 per day (Lifetime Reserve Days)
  • All costs for each day beyond 150 days

Note: You have 60 Lifetime Reserve Days available at day 91

Part B Outpatient Deductible: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)

  • $166.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $166.00 deductible.)

Skilled Nursing Facility Co-insurance

  • Days 1 - 20: Medicare Covers
  • Days 21 - 100: $161.00 per day
  • All costs for each day beyond 100 days.

In addition to your deductible, you may be liable for co-insurance.