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Part A Inpatient Benefits |
Services Covered by Medicare |
| Hospital Inpatient | |
| 1st day to 60th day | You pay $792 hospital deductible per benefit period |
| 61st day to 90th day | You pay $198 per day |
| Beyond 90 days | You pay $396 per day beyond 90 days on each of 60 lifetime days |
| Inpatient Psychiatric Hospital Care | You pay $792 hospital deductible per benefit period limited to 190 days lifetime maximum |
| Skilled Nursing Facility | |
| 21st day to 100th day | You pay $99 per day after 3 day hospital stay. Limit 100 days per benefit period |
Part B Medical Services |
Services Covered by Medicare |
| Physician services | You pay a $100 annual deductible, a 20% co-insurance |
| including primary, | and the remaining charges above the Medicare approved |
| specialist, podiatric, | amount. Both the Medicare deductible and the |
| OB/GYN and chiropractic | Medicare coinsurance are based on Medicare's |
| Surgical services | approved amounts. The approved amount may be all. |
| including surgeon and | of the bill, some portion of the bill or none of the bill |
| anesthesiologist | |
| Diagnostic services | For example |
| including laboratory tests | If you have medical services costing $1000 |
| and x-rays (outpatient) | Medicare then approves $600 |
| PAP Smears and Mammography | Medicare will pay 80% of the amount approved |
| Immunizations | Medicare pays 80% of $600 or $480 |
| (Flu and Hepatitis B) | You would be responsible for $1000 less $480 |
| Ambulance transportation | You would owe $520 to the providers in this example |
| Emergency Room Services | |
| Therapy | |
| Physical, speech and | |
| occupational | |
| Durable medical equipment | |
| Psychiatric physician care | |
| BLOOD | You pay for the first 3 pints of blood used each year |
| Transfusion of blood and bloodcomponents | unless you have paid for them as part of your hospital |
| stay. For additional pints you pay 20% of the | |
| approved amount | |
| Home Health Care | Unlimited visits for up to 21 consecutive days |
Services Not Covered |
Services Covered by Medicare |
| Routine Prescription drugs | Oral Cancer and Immunosuppressive drugs covered Part B |
| Dental Services | |
| Routine Eye Exams | |
| Routine Hearing Exams |
For costs and complete details of coverage, please contact: John K. Arnold
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