Medicare Out Of Pocket Expenses

ORIGINAL MEDICARE - Out Of Pocket Expenses 

The following are examples of some of the more common out of pocket expenses under original Medicare:

Inpatient Hospital Care: You pay for days 1-60 an initial deductible of $1316.00. For days 61-90, you pay $329.00 each day. For days 91-150 you pay $658.00 per day. You pay 100% thereafter.

Skilled Nursing Facility: For days 1-20 you pay nothing. For days 21- 100 you pay $164.50 per day. You pay 100% thereafter.

Doctor Office Visits: After you pay your $183.00 annual deductible, you pay 20% of Medicare approved charges/amounts. If the doctor does not accept Medicare assignment as payment in full, you must pay an additional 15% of the charges.

Chiropractic Services: You pay 20% of Medicare approved charges/ amounts for manual manipulation of the spine to correct subluxation. If the chiropractor does not accept Medicare assignment as payment in full, you must pay an additional 15%.

Outpatient Surgery: You pay 20% of Medicare approved amounts for the doctor and the outpatient facility charges.

Ambulance: You pay 20% of Medicare approved amounts.

Emergency Care: You pay 20% of the facility charge and 20% of the emergency room physicians’ charges.

Diagnostic Tests, X-Rays and Lab Services: You pay 20% of Medicare approved amounts except for approved lab services.

For details as to how Medicare pays for doctor visits, click the button below for a free white paper by Cristina Boccuti of the Kaiser Family Foundation.

White Paper PDF

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