Medicare Part A and B Chart

This Medicare Part A and B Chart will help you understand the differences in Medicare costs and coverages. Use the chart below to see what is covered by Medicare Part A and Medicare Part B.

If you have a question, please contact us. Our trained Medicare Instructors will be happy to answer your questions about Medicare coverages and help you find a Medicare Supplement Plan to fit your personal needs.

Medicare Part A Chart – 2017 Medicare Hospital Insurance
Coverage includes costs associated with stays in a hospital or skilled nursing facility
When You Are Hospitalized For
Medicare Pays
You Pay
Days 1-60
Most hospitalization costs after the required Medicare deductible
$1,316 Deductible
Days 61-90
All eligible expenses, after you pay a per day co-payment
$329 per day co-payment
(Potentially as much as $9,870)
Days 91+
While using 60 lifetime reserve days
All eligible expenses, after you pay a per day co-payment (These are lifetime reserve days which you may never use again)
$658 per day co-payment
(Potentially as much as $39,480)
After 60 lifetime reserve
days are used
Nothing
You Pay ALL Costs
Blood
After first the pints of blood, 100% of Medicare approved amount
First three pints of blood
Skilled Nursing Facility
When you are hospitalized for 3+ days and enter a Medicare approved skilled nursing facility within 30 days after hospital discharge.
Day 1-20
All expenses
$0 for first 20 days
Day 21-100
All except $164.50 per day co-pay
$164.50 per day co-payment for days 21-100
(Potentially as much as $13,160)
Day 100+
ZERO
You Pay ALL Costs
Hospice Care
You must meet Medicare’s requirements including a doctor’s certification of terminal illness.
Hospice Care
All expenses related to a Medicare approved Hospice program with limited co-payment or co-insurance.
$5 for each prescription drug for pain relief & symptom control
5% of medicare approved amount for inpatient respite care.
Medicare Part B Chart – 2017 Medical Insurance
Coverage includes physician services, outpatient care, tests, and supplies
Expenses Incurred For
Medicare Pays
You Pay
Annual Deductible
ZERO
$183 Per Year
Medical Expenses
Generally 80% of Medicare approved amount
Physicians can charge 15% over Medicare approved amounts
20% of Medicare approved amount
Up to 15% of Medicare excess charge coverage
Clinical Laboratory Servicies
Generally 100% of Medicare approved amount
Nothing for Medicare approved services
Outpatient Hospital Treatment
Medicare payment to hospital based on outpatient procedure payment rates
Co-payment based on outpatient procedure payment rates
Blood
After first the pints of blood, 80% of Medicare approved amount
First three pints plus 20% of Medicare approved amount for additional pints
Covered Under Medicare Parts A and B
Home Health Care
100% of approved amount; 80% of approved amount for durable medical equipment
Nothing for Medicare approved services; 20% of Medicare approved amount for durable medical equipment

The supplemental insurance coverages below can cover the gaps in Medicare coverages.

Comparison of Medicare Supplement Plans F G and N
Medicare Part A Coverages for Medical Services – Per Benefit Period
Coverage includes costs associated with stays in a hospital or skilled nursing facility
Services
Medicare Pays
Plan F Pays
You Pay
Plan G Pays
You Pay
Plan N Pays
You Pay
Hospitalization
Semi private room and board, general nursing, and miscellaneous services & supplies.
Days 1-60
All but $1,316
$1,316 (Part A Deductible)
$0
$1,316 (Part A Deductible)
$0
$1,316 (Part A Deductible)
$0
Days 61-90
All but $329 a day
$329 a day
$0
$329 a day
$0
$329 a day
$0
Days 91+
60 Lifetime reserve days
All but $658 a day
$658 a day
$0
$658 a day
$0
$658 a day
$0
Additional 365 Days
Once lifetime reserve days are used
$0
100% of Medicare eligible expenses
$0
100% of Medicare eligible expenses
$0
100% of Medicare eligible expenses
$0
Beyond 365 Days
$0
$0
All Costs
$0
All Costs
$0
All Costs
Skilled Nursing Facility
Must meet Medicare requirements: a Hospital stay of 3+ days and entering a Medicare approved facility within 30 days of leaving the Hospital.
Days 1-20
All approved amounts
$0
$0
$0
$0
$0
$0
Days 21-100
All but $161
a day
Up to $161
a day
$0
Up to $161
a day
$0
Up to $161
a day
$0
Days 101+
$0
$0
All Costs
$0
All Costs
$0
All Costs
Blood
First 3 Pints
$0
3 Pints
$0
3 pints
$0
3 pints
$0
Additional Pints
100%
$0
$0
$0
$0
$0
$0
Hospice Care
Must meet Medicare requirements
All but co-payment co-insurance
Medicare co-payment
co-insurance
$0
Medicare co-payment
co-insurance
$0
Medicare co-payment
co-insurance
$0
Medicare Part B Coverages for Medical Services – Per Calendar Year
Coverage includes physician services, outpatient care, tests, and supplies
Services
Medicare Pays
Plan F Pays
You Pay
Plan G Pays
You Pay
Plan N Pays
You Pay
Medical Expenses
2017 Part B Deductible
$0
$183 Part B Deductible
$0
$0
$183 Part B Deductible
$0
$183 Part B Deductible
Remainder of Medicare Approved Amounts
Generally 80%
Generally 20%
$0
Generally 20%
$0
Covers the Balance except for your co-payment
$20 per office visit and $50 per emergency room visit
Part B Excess Charges
$0
100%
$0
100%
$0
$0
All Costs
Blood
First 3 Pints
$0
All costs
$0
All costs
$0
All costs
$0
Remainder of Medicare Approved Amounts
80%
20%
$0
20%
$0
20%
$0
Clinical Lab Services
100%
$0
$0
$0
$0
$0
$0
Parts A and B
Home Health Care
Medicare approved services
100%
$0
$0
$0
$0
$0
$0
Durable Medical Equipment First $147 of Medicare approved amount
$0
$183 Part B Deductible
$0
$0
$183 Part B Deductible
$0
$183 Part B Deductible
Remainder of Medicare Approved Amounts
80%
20%
$0
20%
$0
20%
$0

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