Medicare removes a huge amount of the burden of medical expenses for beneficiaries. Still, you are left with set costs for your medical care. Read on to learn what to expect for your costs under Medicare for covered medical expenses.
What Expenses Medicare Covers
Medicare has a multi-part system to categorize your health coverage. Part A and Part B are the standard Original Medicare, and you can add prescription drug coverage with Medicare Part D or access to additional benefits through a Medicare Advantage plan.
Medicare Part A covers expenses tied to your care if you are admitted as an inpatient at a hospital or skilled nursing facility. It also covers hospice care and home health care, with coverage for durable medical equipment and symptom control medications in those instances.
Medicare Part B covers most of your typical medical care, including doctor visits, emergency room visits and outpatient care. This also includes mental health coverage, lab services, immunizations and preventive care services. Some doctor services you receive as an inpatient may be covered under Part B.
What Medicare Pays For Your Medical Expenses
Medicare pays in full for many preventive services, including your flu vaccines and annual screenings.
For your doctor visits and other covered Part B services, Medicare pays 80% of their negotiated “Medicare-approved” amount. Medicare picks up a majority of your hospital costs, leaving beneficiaries with only a deductible and coinsurance instead of the remaining portion.
What You Can Expect To Pay With Medicare
On top of your monthly premiums for Part A and Part B, you can expect to pay deductibles, copayments and coinsurance.
The Part A deductible is $1,600 for each benefit period in 2023, which stretches from the day you are admitted as an inpatient until you have not received inpatient care for 60 days. You pay the Part B deductible once yearly, which is $226 in 2023. When you have met the deductible, Medicare’s coverage kicks in.
As an inpatient, you pay a daily coinsurance for Part A coverage. Those costs differ for hospital and skilled nursing facility care, and they count days within a single benefit period. If you are in the hospital in February and again in October, your day count starts again at 0.
For most medical expenses covered under Medicare Part B, you can expect to pay 20% of the Medicare-approved amount. With partial hospitalization for mental health care, you will also owe a daily coinsurance.
If you have a question about your costs for a specific test, item or service, you can check Medicare’s website and ask the health care facility for the expected costs before you have the procedure or make the purchase.
The experienced agents at Magellan Healthcare are here to help you understand your Medicare coverage and make sure it works for you. Give us a call today to learn about your options.