Saturday, October 3, 2009

Medicare co insurance and Deductible


The beneficiary must pay some fixed amount in approved charges for covered Part B medical expenses each calendar year, and can be met by any combination of claims. Deductibles do not apply to flu and pneumococcal injections, clinical laboratory services, screening mammograms, pap smear collection, pelvic and breast exams, and prostate specific antigen (PSA) tests.


Coinsurance is the portion or percentage of Medicare's approved amounts for covered services that a beneficiary is responsible for paying. Usually, the coinsurance portion is 20% of the Medicare approved amount. There is no coinsurance for those services that pay at 100%.

Note: The coinsurance will be higher for certain outpatient psychotherapy services.

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