Understanding Medicare Deductibles

There has been a lot of confusion regarding Medicare deductibles and we hope the following information will help. A woman on Medicare went to the hospital on January 2, 2009 and for that visit, her Part A deductible was charger, in the amount of $1,068 for 2009. She thought she was finished for the year. She was put back in the hospital in late May, 2009, and was again charged the $1,068 deductible. She was extremely confused because she had already paid in January. The explanation below from the Capital Gazette in Maryland is an excellent and clear explanation of how this could happen and how Medicare deductibles on Part A and B work.

Medicare Part A and Medicare Part B have deductibles. In 2009, the Part B deductible is $135. Your Part B deductible is billed only once per calendar year.

Part A, your inpatient hospital insurance, has a deductible of $1,068 for 2009. But the Part A deductible is not set on a calendar year basis; the Medicare Part A deductible is for a benefit period.

Your “Medicare and You” handbook states a benefit period begins on “the day you go to a hospital or skilled nursing facility.

The benefit period ends when you haven’t received any inpatient hospital care or inpatient skilled nursing care for 60 days in a row. If you go into a hospital or skilled nursing facility after one benefit period has ended, a new benefit period begins.”

When a new benefit period begins, you are responsible for a new Part A deductible. Some people consider purchasing a Medigap plan to cover the out-of-pocket costs for the Medicare Part A and Part B deductibles.

Another option you have is to review the costs of care under a Medicare Advantage Plan.

Call 800-MEDICARE, visit www.medicare.gov on the internet or contact your local Medicare Office for help.

This situation can be very confusing and costly. It is important when you contact Medicare that you determine whether there is Medicar Advantage Plan or Supplement that can help you. For instance, if there is a Medical Advantage Plan that will help with the Part A deductible and it costs #50 per month (you need to call for rates), that cost per year would be $600. If that could be paid for the supplement, you would be saving $1,000 every time you needed to pay a deductible for a new benefit period.

When you contact Medicare they can also help you by having you work with their online calculator which helps determine rates for plans and gives other information.

Amy Rubino, who provided some of this information is the director of Senior Health Insurance Assistance Program for the Anne Arundel County Department of Aging and Disabilities.