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Your Cost Sharing in the Original Medicare Plan in 2012

Part A Costs for Covered Services and Items

Blood

 

You pay all costs for the first three pints of blood you get as an inpatient, then 20% of the Medicare-approved amount for additional pints of blood (unless donated to replace what is used).

Home Health Care

 

You pay

  • $0 for home health care services
  • 20% of the Medicare-approved amount for durable medical equipment

Hospice Care

 

You pay a copayment of up to $5 for outpatient prescription drugs and 5% of the Medicare-approved amount for inpatient respite care (short-term care given by another caregiver so the usual caregiver can rest).

Hospital Stay

You pay

  • $1,156 for days 1-60 each benefit period
  • $289 per day for days 61-90 each benefit period
  • $578 per day for days 91-150 each benefit period
  • All costs for each day over 150 days ("Lifetime reserve days" are 60 extra days of coverage you can use in your lifetime.

Skilled Nursing Facility Stay

 

You pay

  • $0 for the first 20 days each benefit period
  • $144.50 per day for days 21-100 each benefit period
  • All costs for each day after day 100 in the benefit period 
Part B Costs for Covered Services and Items

Blood

 

You pay all costs for the first three pints of blood you get as an outpatient, then 20% of the Medicare-approved amount for additional pints of blood (unless donated to replace what is used).

Clinical Laboratory Service

 

You pay $0 for Medicare-approved services.

Deductible

You pay the first $140 yearly for Part B-covered services or items.

Home Health Services

 

You pay $0 for Medicare-approved services. You pay 20% of the Medicare-approved amount for durable medical equipment.

Medical and Other Services You pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy*, most preventive services and durable medical equipment.
Mental Health Services You pay 40% for outpatient mental health care
Other Covered Services You pay copayment and coinsurance amounts.
Outpatient Hospital Services You pay a coinsurance or copayment amount that varies by service.

Items and services that Medicare does not cover include, but are not limited to, long-term care, routine dental care, dentures, cosmetic surgery, acupuncture, hearing aids, and exams for fitting hearing aids.

To find out if Medicare covers a service you need, visit www.medicare.gov and select "Find Out if Medicare Covers Your Test, Item or Service" or call 1-800-MEDICARE.