Posts Tagged ‘medicare physicians’

Medicare Part B (2010)

Wednesday, May 26th, 2010

Part B is Medical Insurance and covers physicians services, outpatient care, test, and supplies.

On Expenses
incurred for:
Medicare Covers You Pay $155 Annual Part B Deductible PLUS

Physicians services, inpatient, outpatient medical/surgical services, physical/speech therapy, diagnostic test.

80% of approved amount 20% of approved amount
Clinical Laboratory Services
Blood Test, Urinalysis
Generally 100% of approved amount Nothing for Services
Home Health Care
Part-time or intermittent skilled care, home health aide services, durable medical supplies and other services.
100% of approved amount; 80% of approved amount for durable medical equipment Nothing for Services; 20% of approved amount for durable medical equipment
Outpatient Hospital Treatment
Services for the diagnosis or treatment of an illness or injury
Medicare payment to hospital based on hospital cost 20% of Billed Amount
Blood

After first 3 pints of blood, 80% of approved amount

First 3 pints plus 20% of approved amount for additional pints

On all Medicare-covered expenses, a doctor or other health care provider may agree to accept Medicare “assignment.” This means the patient will not be required to pay any expense in excess of Medicare’s “approved” charge. The patient pays only 20% of the “approved” charge not paid by Medicare.

Physicians who do not accept assignment of a Medicare claim are limited as to the amount they can charge for covered services.

Glossary

Friday, May 21st, 2010

Medicare Terms Defined

For Complete Glossary click here

Lifetime Reserve Days

are limited to 60 days during your life. After these reserve days are used, Medicare provides no hospital coverage after 90 days of a benefit period.

Medicare Eligible Expenses

are expenses which are recognized as reasonable and medically necessary by Medicare. Physicians under Medicare may accept Medicare’s Eligible Expense as their fee amount. Your physician may also charge you more.

Skilled Nursing Facility

provides skilled nursing care and is approved for payment by Medicare or may qualify to receive such approval. Custodial care is not an eligible expense.

Excess Charges

is the difference between the actual charge as billed, and the Medicare approved Part B charge.

Medicare (Part A)

Hospital Services for semiprivate room and board, general nursing and miscellaneous services and supplies. Benefit period applies.

Medicare (Part B)

Medical services in or out of the hospital and outpatient hospital treatment, such as physician services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, and durable medical equipment.

Benefit Period

defines the limit of a stay at a hospital or nursing facility and what benefits you receive for that stay.

Special Notes:

The sale of duplicate Medicare Supplement coverage is prohibited.
Your coverage can never be canceled because of your age, your health, or the number of claims you make as long as you make payments when due.
Consult your local insurance professional for specific information.