|
|||
|
|
|
 |
Understanding Your Medicare Deductible 2006 Premiums, Deductibles and Coinsurances For most services covered under Medicare Part B, you must pay a deductible and coinsurance as explained below. The Annual Deductible You must pay the annual deductible for covered medical expenses annually. This is called the Medicare Part B annual deductible. You need to meet the deductible only once during the year, and the deductible may be met through any combination of covered expenses. You do not have to meet a separate deductible for each different kind of covered Part B service you receive. Do not send your deductible to Medicare; your deductible payment should be made to your doctor. Medicare will apply your deductible on the first claims that are approved and finalized -- regardless of the order in which they were submitted. Useful information about your deductible is in your Medicare Summary Notice (MSN) statement. You will receive a MSN for most medical services you receive. It will explain which amounts were applied toward your annual deductible. If your doctor asks you to pay your deductible when he or she provides the service, request a delay in payment until you receive your MSN. This will help reduce confusion. No one can be sure which of your claims will be applied to your deductible. Wait until you receive an MSN to be sure you are paying your deductible properly. We encourage you not to pay for services when you receive them. Wait until Medicare and your Medigap have reviewed and paid their portions. The Blood Deductible Unless you have already done so under your Part A benefit, you must pay for or replace the first three pints or units of blood and blood components you use each year. This is called the Medicare Part B blood deductible. After you have replaced or paid for the first three pints of blood and have met the annual deductible, Medicare will pay 80 percent of the approved amount for blood, starting with the fourth pint. Coinsurance After you pay the annual deductible, you will owe a share of the Medicare-approved amount for most services and supplies. This share is called coinsurance. Usually, your coinsurance share is 20 percent of the Medicare-approved amount. If your services were provided ‘on assignment’, you pay only the coinsurance. Always ask if your doctor accepts Medicare assignment. If he or she does accept Medicare assignment, your 20% coinsurance will be the amount up to the Medicare-approved amount, NOT the dollar amount the doctor submitted to Medicare for rendered services. If your services were not provided ‘on assignment’, and the charges for your services were more than the Medicare-approved amount, you usually owe the Medicare coinsurance plus certain charges above the Medicare-approved amount. Most physicians across the country accept Medicare assignment. Besides having to pay Medicare’s deductibles and coinsurance, you are responsible for all charges for services and supplies you receive that are not covered by Medicare. If you receive a bill and you're not sure if you should pay it, call your Medicare beneficiary services: 1-800-MEDICARE (1-800-633-4227)/1-877-486-2048 (TTY) 11/20/2008 |
