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Your Costs through Medicare

The total amount you end up paying for your health care each year depends on a variety of factors:

  • What type of care you need
  • How often you require health care
  • If you use health services not covered by your insurance.
  • Whether you have both Medicare Parts A and B. Most people do.
  • Whether your doctor “accepts assignment,” that is whether he or she agrees to charge you the amount Medicare will pay for a given service.
  • Whether you have other health insurance to fill any “gaps.”

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Even if you have both Medicare Parts A and B, you will need to pay some of your health care costs. Here is a list of costs you can expect to pay in 2006 (in addition to any premiums you pay for Parts A or B):

General
Deductible for Part B  $124
Medical Costs (after you meet the deductible) 20%
Medicare-approved charges for doctor services, outpatient  therapy, preventive services, and durable medical equipment   20%
Most outpatient mental health services’ costs 50%
Copayments and coinsurance amounts for other services All Costs
Hospital Costs
For each hospital stay up to 60 days.  $952
For each day over 60 (up to 90) spent in the hospital. $238
For each day over 90 (up to 150) spent in the hospital  (Lifetime Reserve Days). $476
For each day over 150 days spent in the hospital. All Costs
Skilled Nursing Facility Costs
For each day, for days 21 through 100 in a skilled nursing facility. $119
For each day after 100 days in a skilled nursing facility. All costs
Blood Supplies
First 3 pints of blood received as an inpatient (unless you or someone else donates the blood) All costs
First 3 pints of blood received as an outpatient. All costs
Additional pints of blood received as an outpatient (unless you or someone else donates the blood)  20%

There may also be limits on physical therapy, occupational therapy and speech-languages services. For details, contact Medicare directly.

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