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Medicare doesn't pay for 100% of your hospital costs

Does Medicare Cover All Hospital Bills?

Medicare is the leading health insurance for Americans aged 65 and over. According to CMS, more than 60 million people are covered by Medicare. However, while it covers most medically necessary hospital bills, it doesn’t pay for 100% of your hospital costs. This article gives you the idea of what hospital bills Medicare pays for and doesn’t pay for. 

Costs and Coverage for Inpatient Hospital Care

When admitted as an inpatient to a hospital, you are required to pay a deductible for each benefit period. There is no coinsurance for the first 60 days, but after 60 days, there will be an everyday coinsurance you must pay. Medicare Part A hospital insurance benefits include nurse’s services, X-rays, medically necessary drugs, appliances, equipment, and supplies the hospital provides for your use during the inpatient hospital stay.

However, Medicare doesn’t cover procedures or treatments that are considered experimental. Also, if your hospital stay extends beyond 60 days, you will be responsible for more of the cost of your care. Beyond the 90th day of your hospital stay, you will start tapping into your 60-day lifetime reserve. In addition, Part B helps Medicare beneficiaries cover the doctor’s services they receive while in the hospital. However, you are responsible for 20% coinsurance for these doctor’s services.

Costs and Coverage for Outpatient Hospital Care

When Medicare Part B covers your hospital stay, you generally have to pay a coinsurance for each of the medical services you receive while at the hospital, and it will also be after you meet the Medicare Part B deductible. For instance, you will have separate charges for observation care, lab tests, emergency room care, and x-rays. Moreover, you must pay the coinsurance for the doctor’s service you receive.

The doctor’s services include the time you spent with a doctor while you were still in the hospital, even if that medical professional is not your primary surgeon or doctor. Medicare Part B typically covers 80% of most of the services you receive after meeting your annual Medicare Part B deductible. In most cases, you are required to pay the remaining 20% coinsurance.

Ways to Reduce Medicare Costs

It may be possible for you to pay less hospital bills – some Medicare Advantage or Medicare Supplement plans can help reduce the out-of-pocket expenses for hospital treatment. For instance, Medicare beneficiaries that opt for Medicare Advantage plans instead of Original Medicare may have lower out-of-pocket costs like daily hospital copayments. However, these plans vary in their level of coverage as they can restrict your coverage to certain provider networks. If you receive care outside the plan’s network of providers, you will either have to pay more or all of the costs.

Medicare Supplements are supplemental policies that are available to Medicare beneficiaries who enrolled for Original Medicare. The policies cover costs that Medicare Part A and B don’t cover, such as out-of-pocket costs, like deductibles, coinsurance, copayments, excess charges, and more.

If you have any questions about whether a Medicare insurance plan will pay for all of your hospital bills, contact Cornerstone Senior Advisors today.