Medicare Part A

Based on 2006 Data

Services
Benefit
Medicare Pays
You Pay
Hospitalization per benefit period - Footnote 1
1 - 60 Days
All covered services except for a deductible
$952 per benefit period for up to 60 days of Medicare-covered services
Semiprivate room and board, general nursing and miscellaneous
61 - 90 Days
Covered services except for a daily coinsurance amount
$238 a day
Hospital services and supplies
91 - 150 Days
(60 Reserve Days)
Covered services except for a daily coinsurance amount
$476 a day

Skilled Nursing Facility

Footnote 2

1- 20 Days
100% of Approved Amount Nothing
21 - 100 Days
Covered services except for a daily coinsurance amount $119 a day
Over 100 Days
Nothing Everything
Home Health Care
Visits limited to medically necessary skilled care, unlimited as long as you meet Medicare requirements for home health benefits
Full costs of services; 80% of approved amount for durable medical equipment
Nothing for services; 20% of approved amount for durable medical equipment
Hospice Care
As long as doctor certifies need
All but limited costs for outpatient drugs and inpatient respite care
Limited cost sharing for outpatient drugs and inpatient respite care
Blood
Unlimited during benefit period, if medically necessary
All but first three pints per calendar year
For first three pints
Footnote 1 -- 60 reserve days may be used only once
Footnote 2 -- 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 or skilled nursing facility for 60 days in a row. You must have been in a hospital for at least three days and enter a Medicare-approved facility generally within 30 days after medical discharge. Medicare and private insurance will not pay for most nursing home care.
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