Summary of Medicare Benefits and Cost-Sharing for 2008
| Service Provided | Medicare Pays | You Pay |
|---|---|---|
| Hospital Inpatient | ||
| Days 1-60 | Everything after deductible | $1,024 deductible |
| Days 61-90 | Everything after co-payment | $256 per day co-payment |
| 60 Reserve Days | Everything after co-payment | $512 per day co-payment |
| Beyond 150 Days | Nothing | All costs for each day beyond 150 Days |
| Psychiatric Hospital | Same as hospital inpatient but 190 day lifetime limit | All costs after 190 days |
| Skilled Nursing Facility (SNF) (if daily skilled care is needed after a three day hospital stay) |
||
| Days 1-20 | All | Nothing |
| Days 21-100 | All after co-payment | $128 per day co-payment |
| After 100 Days | Nothing | All |
| Home Health Care | All except 20% of covered medical equipment | 20% of Medicare Approved amount for medical equipment |
| Hospice (care of terminal illness) | All except $5 per prescription and 95% of Medicare approved amount for respite care per day | Co-payment of $5 per prescription and for respite care, 5% of Medicare payment for a respite care day, not to exceed $1,024 |
| Blood (received during hospital or SNF stay) | After 3 pints of blood | The first 3 pints of blood each year |
| Note 1: Each of the 60 reserve days may be used only once in an individual’s lifetime. | ||
| Service Provided | You Pay | |
|---|---|---|
| Monthly Premium This is the amount of the monthly Part B premium for individuals who have an annual income ≤$82,000, or ≤$164,000 for couples. |
$96.40 | |
| For individuals with incomes >$82,000 and ≤ $102,000, or couples with incomes >$164,000 and ≤$204,000 | $122.20 | |
| For individuals with incomes >$102,000 and ≤$153,000 or couples with incomes >$204,000 and ≤$306,000 | $160.90 | |
| For individuals with incomes >$153,000 and ≤$205,000, or couples with incomes >$306,000 and ≤$410,000 | $199.70 | |
| For individuals with incomes >$205,000 and couples with incomes >$410,000 | $238.40 | |
| Service Provided | Medicare Pays | You Pay |
| Annual Deductible | $135/year | |
| Physician Costs | 80% of approved amount | 20% of approved amount, plus up to an additional 15% of the Medicare approved amount if the doctor or supplier does not accept assignment. |
| Outpatient Hospital Care | 80% of approved amount | A maximum of $1,024 |
| Clinical Lab Services | Approved amount | Nothing |
| Medical Equipment/Supplies | 80% of approved amount | All other costs |
| Some Preventive Services (depending on the service, some are covered according to a time schedule, i.e. once a year) | 80% or 100% | 20% of approved amount or nothing, depending on the service |
| Mental Health Services | ||
Partial Hospitalization |
Same as inpatient hospital | See above under Part A |
Outpatient |
50% of approved amount | 50% of approved amount |
