Problem:

Mrs. P is going to have an operation soon and will need to be in the hospital for about two weeks. She is concerned that she will have to pay a lot for the hospital stay under Original Medicare. She does not have supplemental insurance.

What To Do:

Mrs. P called her State Health Insurance Assistance Program (SHIP) to find out more about how much she will have to pay. She found out since she does not have any supplemental coverage, she must pay the Medicare Part A deductible and coinsurance related to her hospital stay. This means that she pays only a deductible for her hospital stay for the first 60 days ($1,316 in 2017). If she needed to stay in the hospital longer than expected, she would have to pay a daily coinsurance for the following 30 days ($329 a day in 2017 for days 61 through 90). After 90 days, she has 60 lifetime reserve days she can use for which she pays $658  a day. She is responsible for all costs beyond 150 days (or after she has used all her reserve days). As Mrs. P’s hospital stay is likely to be no longer than two weeks, she will only have to pay the deductible. Also, Mrs. P will need to pay for physician services you receives while she is in the hospital.Original Medicare Part B generally covers 80 percent of the cost of most doctors’ services you receive, after you’ve met your yearly deductible. In most cases, you are responsible in paying the remaining 20 percent coinsurance.

For more information on when to enroll into Medicare Part B, please click here.

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