Billing Policies > Medicare Policies

We bill Medicare for inpatient and outpatient services. Supplemental insurance will also be billed, at the patient's request, if information is provided at the time of service. Patients are responsible for any charges not covered by Medicare and/or supplemental insurance.

Medicare Deductible and Coinsurance Amounts for 2020

Part A Inpatient Deductible: (pays for inpatient hospital, skilled nursing facility, and some home health care)

For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2020 = $1,408) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days. For each benefit period you pay:

  • Days 1 - 60 $1,408.00
  • Days 61 - 90 $352.00 per day
  • Days 91 - 150 $704.00 per day (Lifetime Reserve Days)
  • All costs for each day beyond 150 days

Note: You have 60 Lifetime Reserve Days available at day 91

Part B Outpatient Deductible: (covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)

  • $198.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $198.00 deductible.)

Skilled Nursing Facility Co-insurance

  • Days 1 - 20 Medicare Covers
  • Days 21 - 100 $176.00 per day

In addition to your deductible, you may be liable for co-insurance.

Additional information regarding Medicare can be found on the Medicare Frequently Asked Questions page.

Prescription Drug Coverage: Basic Information

What is Medicare prescription drug coverage?
Medicare prescription drug coverage is insurance that covers both brand-name and generic prescription drugs at participating pharmacies in your area. Medicare prescription drug coverage provides protection for people who have very high drug costs or from unexpected prescription drug bills in the future.

Who can get Medicare prescription drug coverage?
Everyone with Medicare is eligible for this coverage, regardless of income and resources, health status, or current prescription expenses.

When can I get Medicare prescription drug coverage?
You may sign up when you first become eligible for Medicare (three months before the month you turn age 65 until three months after you turn age 65). If you get Medicare due to a disability, you can join from three months before to three months after your 25th month of cash disability payments. If you don't sign up when you are first eligible, you may pay a penalty. If you didn't join when you were first eligible, your next opportunity to enroll will be from November 15, 2020 to December 31, 2020.

How does Medicare prescription drug coverage work?
Your decision about Medicare prescription drug coverage depends on the kind of health care coverage you have now. There are two ways to get medicare prescription drug coverage. You can join a Medicare prescription drug plan or you can join a Medicare Advantage Plan or other Medicare Health Plan that offers drug coverage.

Whatever plan you choose, Medicare drug coverage will help you by covering brand-name and generic drugs at pharmacies that are convenient for you.

Like other insurance, if you join, generally you will pay a monthly premium, which varies by plan, an a yearly deductible (between $0 - $265 in 2007). You will also pay a part of the cost of your prescriptions, including a copayment or coinsurance. Costs will vary depending on which drug plan you choose. Some plans may offer more coverage and additional drugs for a higher monthly premium. If you have limited income and resources, and you qualify for extra help, you may not have to pay a premium or deductible. You can apply or get more information about the extra help by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or visiting www.socialsecurity.gov.

Why should I get Medicare prescription drug coverage?
Medicare prescription drug coverage provides greater peace of mind by protecting you from unexpected drug expenses. Even if you don't use a lot of prescription drugs now, you should still consider joining. As we age, most people need prescription drugs to stay healthy. For most people, joining now means protection from unexpected prescription drug bills in the future.

What if I have a limited income and resources?
There is extra help for people with limited income and resources. Almost 1 in 3 people with Medicare will qualify for extra help. If you qualify for extra help, Medicare will pay for almost all of your prescription drug costs. You can apply or get more information about the extra help by calling Social Security at 1-800-772-1213 (TTY 1-800-325-0778) or visiting www.socialsecurity.gov.