|
Chart 1: Medicare Part A Covered Services for 2001 |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
Hospitalization:
Semiprivate room and board, general nursing and other hospital services and supplies, (Medicare payments base on benefit periods). |
| First 60 days |
| 61st to 90th day |
| 91st to 150th day* |
| Beyond 150 days |
|
| All but $792 |
| All but $198 a day |
| All but $396 a day |
| NOTHING |
|
| $792 |
| $198 a day |
| $396 a day |
| ALL COSTS |
|
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
Skilled Nursing Facility Care: Semiprivate room and board, skilled nursing and rehabilitative services and other services and supplies.** (Medicare coverage based on benefit periods). |
First 20 Days |
100% of approved amount. |
NOTHING |
| Additional 80 days |
All but $99.00 a day |
Up to $99.00 a day |
| Beyond 100 days |
NOTHING |
ALL COSTS |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
Home Health Care:
Part-time or intermittent skilled care, home health aide services, durable medical equipment and supplies and other services. |
Unlimited as long as you meet Medicare requirements for home health care benefits. |
100% of approved amount for services;80% of approved amount for durable medical equipment. |
Nothing for services; 20% of approved amount for durable medical equipment. |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
| Hospice Care: |
| Pain relief, symptom management and support services for the terminally ill. |
For as long as doctor certifies need. |
All but limited costs for outpatient drugs and inpatient respite care. |
Limited cost sharing for outpatient drugs and inpatient respite care. |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
| BLOOD: |
| When furnished by a hospital or skilled nursing facility during a covered stay. |
Unlimited during a benefit period if medically necessary. |
All but 3 pints per calendar year. |
For first 3 pints.*** |
|
(*Subject to change without notice)
Chart 2: Medicare Part B Covered Services for 2001
 |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
MEDICAL EXPENSES Physician's services, inpatient and Outpatient medical and surgical services and supplies, physical, occupational and speech therapy, diagnostic tests, and durable medical equipment |
Unlimited services if medically necessary, except for the services of independent physical and occupational therapists. |
80% of approved amount (after $100 deductible); 50% of approved amount for most outpatient mental health services; up to $720 a year each for independent physical therapy. |
100% deductible; 20% of approved amount after deductible; charges above approved amount;**50% for most outpatient mental health services; 20% of first $900 for each independent physical and occupational therapy and all charges thereafter each year. |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
CLINICAL LABORATORY SERVICES Blood test, urinalysis, and more. |
Unlimited if medically necessary. |
Generally 100% of approved amount. |
Nothing for Services. |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
HOME HEALTH CARE Part-time or intermittent skilled care, Home health aide services, durable medicalEquipment and supplies and other services. |
Unlimited as long as you meet Medicare requirements. |
100% of approved amount for services; 80% of approved amount for durable medical equipment. |
Nothing for services; 20% of amount Medicare approves for durable medical equipment. |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
OUT PATIENT HOSPITAL SERVICES Services for the diagnosis or treatment of An illness or injury. |
Unlimited if medically necessary. |
Medicare payment to hospital based on hospital costs. |
20% of whatever the hospital charges (after $100 deductible).* |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
| BLOOD |
Unlimited if medically necessary. |
80% of approved amount (after $100 deductible and starting with 4th pint). |
First 3 pints plus 20% of approved amount for additional pints (after $100 deductible).*** |
|
|
Chart 1: Medicare Part A Covered Services for 2001 |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
Hospitalization:
Semiprivate room and board, general nursing and other hospital services and supplies, (Medicare payments base on benefit periods). |
| First 60 days |
| 61st to 90th day |
| 91st to 150th day* |
| Beyond 150 days |
|
| All but $792 |
| All but $198 a day |
| All but $396 a day |
| NOTHING |
|
| $792 |
| $198 a day |
| $396 a day |
| ALL COSTS |
|
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
Skilled Nursing Facility Care: Semiprivate room and board, skilled nursing and rehabilitative services and other services and supplies.** (Medicare coverage based on benefit periods). |
First 20 Days |
100% of approved amount. |
NOTHING |
| Additional 80 days |
All but $99.00 a day |
Up to $99.00 a day |
Beyond 100 days |
NOTHING |
ALL COSTS |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
Home Health Care:
Part-time or intermittent skilled care, home health aide services, durable medical equipment and supplies and other services. |
Unlimited as long as you meet Medicare requirements for home health care benefits. |
100% of approved amount for services;80% of approved amount for durable medical equipment. |
Nothing for services; 20% of approved amount for durable medical equipment. |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
| Hospice Care: |
| Pain relief, symptom management and support services for the terminally ill. |
For as long as doctor certifies need. |
All but limited costs for outpatient drugs and inpatient respite care. |
Limited cost sharing for outpatient drugs and inpatient respite care. |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
| BLOOD: |
| When furnished by a hospital or skilled nursing facility during a covered stay. |
Unlimited during a benefit period if medically necessary. |
All but 3 pints per calendar year. |
For first 3 pints.*** |
|
(*Subject to change without notice)
Chart 2: Medicare Part B Covered Services for 2001 |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
MEDICAL EXPENSES Physician's services, inpatient and Outpatient medical and surgical services and supplies, physical, occupational and speech therapy, diagnostic tests, and durable medical equipment |
Unlimited services if medically necessary, except for the services of independent physical and occupational therapists. |
80% of approved amount (after $100 deductible); 50% of approved amount for most outpatient mental health services; up to $720 a year each for independent physical therapy. |
100% deductible; 20% of approved amount after deductible; charges above approved amount;**50% for most outpatient mental health services; 20% of first $900 for each independent physical and occupational therapy and all charges thereafter each year. |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
CLINICAL LABORATORY SERVICES Blood test, urinalysis, and more. |
Unlimited if medically necessary. |
Generally 100% of approved amount. |
Nothing for Services. |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
HOME HEALTH CARE Part-time or intermittent skilled care, Home health aide services, durable medicalEquipment and supplies and other services. |
Unlimited as long as you meet Medicare requirements. |
100% of approved amount for services; 80% of approved amount for durable medical equipment. |
Nothing for services; 20% of amount Medicare approves for durable medical equipment. |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
OUT PATIENT HOSPITAL SERVICES Services for the diagnosis or treatment of An illness or injury. |
Unlimited if medically necessary. |
Medicare payment to hospital based on hospital costs. |
20% of whatever the hospital charges (after $100 deductible).* |
| SERVICE |
BENEFIT |
MEDICARE PAYS |
YOU PAY |
| BLOOD |
Unlimited if medically necessary. |
80% of approved amount (after $100 deductible and starting with 4th pint). |
First 3 pints plus 20% of approved amount for additional pints (after $100 deductible).*** |
| |