|
Services
|
Benefit
|
Medicare
Pays
|
You
Pay
|
|
MEDICAL EXPENSES
Doctors
services, inpatient and outpatient medical and surgical services
and supplies, physical and speech therapy, diagnostic tests,
durable medical equipment, and other services
|
Unlimited if
medically necessary
|
80% if approved
amount (after $100 deductible)
50%
of approved charges for most outpatient mental health services
|
$100 deductible*
plus 20% of approved amount and limited charges above approved
amount
|
|
CLINICAL
LABORATORY SERVICES
Blood tests,
urinalyses and more
|
Unlimited if
medically necessary
|
Generally 100%
of approved amount
|
Nothing for
services
|
|
HOME HEALTH CARE
Part-time or
intermittent skilled care, home health aide services, durable
medical equipment and supplies, and other services.
|
Unlimited as
long as you meet Medicare conditions
|
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 illness or injury
|
Unlimited if
medically necessary
|
Medicare payment
to hospital based on hospital cost
|
20% of billed
amount (after $100 deductible)
|
|
BLOOD
|
Unlimited if
medically necessary
|
80% of approved
amount (after $100 deductible and starting with 4th
point)
|
First 3 pints
plus 20% of approved amount for additional points (after $100
deductible)
|
