If Medicare covers the procedure, you or your supplemental insurance pay:

  • Any unmet portion of the yearly Part B deductible. The deductible is the amount you must pay out of pocket before your insurance coverage begins.
  • Coinsurance or fixed copayment amount for each outpatient service, which cannot be more than the Medicare Part A inpatient hospital deductible ($1,340 in 2018)
  • If the amount you pay for the service is 20% of a hospital’s charges or the Medicare payment rate, it is called the coinsurance. If Medicare charges a fixed payment amount for the service you get, it is called a copayment.

If Medicare does not cover the procedure, you are responsible for all charges for items or services.