What is not covered by Medicare?
Although Medicare provides coverage for a wide range of acute services there are many gaps in its coverage. In addition, there are a number of cost sharing requirements for Medicare beneficiaries. The gaps in coverage and required cost-sharing translate into direct out-of-pocket expenses for Medicare beneficiaries (hence, no claim records), unless they have supplemental insurance coverage, known as medigap insurance. PART A-Hospital Insurance • Hospital Deductible: One deductible is charged per hospital admission ($764 in 1998). Readmission within a 60-day period does not trigger another deductible. • Hospital Coinsurance: From the 61st day to the 90th day of hospitalization, beneficiaries are the responsible for of the hospital deductible ($191 in 1998); from the 91st through the 150th day of hospitalization, coinsurance equals of the hospital deductible ($382 in 1998). • Hospital Coverage Beyond 150 Days: Medicare does not pay for hospital coverage beyond 150 days.
Although Medicare provides coverage for a wide range of acute care services, there are services that are not covered by Medicare. In addition, there are a number of cost-sharing requirements for Medicare beneficiaries. The gaps in coverage and cost-sharing amounts translate into direct out-of-pocket expenses for Medicare beneficiaries (hence, no claim records), unless they have supplemental insurance coverage, known as Medigap insurance. PART A – Hospital Insurance Hospital Deductible: One deductible is charged per hospital admission ($1,024 in 2008). Readmission within a 60-day period does not trigger another deductible. Hospital Coinsurance: From the 61st day to the 90th day of hospitalization, beneficiaries are responsible for ¼ of the hospital deductible ($256 in 2008); from the 91st through the 150th day of hospitalization, coinsurance equals ½ of the hospital deductible ($512 in 2008). Hospital Coverage Beyond 150 Days: Medicare does not pay for hospital coverage beyond 150 days.
