Medicare: How much will your hospital bill be?

Should you get a Medicare supplement to fill the gaps in Medicare?  How much will your bill be if you are admitted to the hospital and you only have Medicare?

A good explanation of how Medicare works when you are admitted to a hospital can be found on the MedicareInteractive.org website. Here is some of the information provided on this site:

If you stay overnight in the hospital, your costs and coverage will depend on whether you have inpatient status or outpatient status in the hospital. Know that staying overnight in the hospital does not make you a hospital inpatient. You only become an inpatient after your doctor formally admits you to the hospital.

In general, doctors will only admit you if they expect you will need to stay at least 2 days overnight in the hospital. Part A covers most care you get when you are an inpatient.

Costs for inpatient hospital care

When you are admitted to a hospital as an inpatient, you pay a one-time deductible for most hospital care provided and then have no copayments for the first 60 days. The Part A hospital benefit  includes nurse’s services, medically necessary medications, X-rays, supplies, appliances, and equipment the hospital provides for you to use during your inpatient hospital stay. Medicare Part B covers doctors’ services you receive in the hospital.  You usually owe a separate 20 percent coinsurance for these doctors’ services.

Costs and coverage for outpatient hospital care

If Part B covers your hospital stay, you typically pay a coinsurance for each medical service you receive in the hospital after you meet the Part B deductible. For example, you will have separate charges for emergency room care, observation care, x-rays and lab tests. You must also pay the coinsurance for physician services you receive. Physician services include any time you spent with a physician while you were in the hospital, even if that physician was not your primary doctor or surgeon. Original Medicare Part B generally covers 80 percent of the cost of most services you receive after you have met your yearly deductible. In most cases, you are responsible in paying the remaining 20 percent coinsurance.

For the full explanation use this link: http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&script_id=1755

Medicare Advantage plans work differently than Medicare.  They have a set co-pay for each day you are in the hospital, for example:  $275 per day days 1-5.  Every service you receive in the hospital is covered by this co-pay, so you don’t have to worry about getting bills from different doctors.

Medicare supplements work differently than Medicare Advantage.  Medicare supplements pay the 20% co-insurance and the Part A deductible (depending on the supplement you choose).

 

 

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2 Responses to "Medicare: How much will your hospital bill be?"

  1. Donald Wechsler says:

    RE: Medicare: How much will your hospital bill be?

    Your comment: “Medicare Advantage plans work differently than Medicare. They have a set co-pay for each day you are in the hospital, for example: $275 per day days 1-5. Every service you receive in the hospital is covered by this co-pay, so you don’t have to worry about getting lots of bills from different doctors.”

    Wouldn’t that statement apply only for for doctors that are on the hospital staff? Would doctors not on staff still be billing separately?

    Thank you.

  2. Denise says:

    If you have a Medicare Advantage plan and your hospital co-pay is $265 per day, that’s all you pay. Every service you receive and every doctor who services you is covered by that co-pay.

    A couple of years ago, I had a client call me to say she had been in the Casa Grande hospital on a weekend because she had a heart attack. A month later she got a bill from one doctor who was working part-time at the hospital. I told her I was glad she called me because she should not have gotten that bill. We called her Medicare Advantage plan and told them to fix this problem. They did.

    Even with outpatient surgery, there should be just one bill – if your Advantage plan has a set co-pay for outpatient surgery. There are some plan that have a 20% co-insurance for outpatient surgery. Read a story I wrote about a while back about a client who got a big bill because his plan had a 20% co-insurance for outpatient surgery. http://medicareblog.org/24-hospital-stay-126000-bill/

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