Deductible- The annual amount that the insured must pay out of pocket for medical services before the health insurance carrier begins to pay. Medicare’s annual deductible for 2014 is $147.
Copayment- A fixed amount that the insured must pay for covered benefits. This amount varies based on the type of service: for example, you may have a $20 copayment for a Primary Care Physician, $40 for a Specialist, and $100 for Emergency Room Services
Co-insurance- A cost-share between the insured and insurance carrier. For example, Medicare Part B pays 80% of all charges; the remaining 20% is the insured’s responsibility.
Medicare Part A- hospital insurance, including inpatient stays, skilled nursing facilities, hospice care, and some home health care
Medicare Part B- medical insurance, including certain physician services, outpatient care, medical supplies and some preventative services
Medicare Part C- Medicare Advantage Plans, plans issued by private insurances (Geisinger Gold and Freedom Blue are examples) to supply your Medicare Part A and B coverage, and in some cases, Part D coverage. By opting into a Medicare Advantage plan, traditional Medicare no longer pays your claims; the Advantage plan you choose is the only Medicare coverage you will have
Medicare Part D- prescription drug coverage
Medicare Supplement Plans- Medicare only pays 80% of all covered charges; it is the patient’s responsibility to pay the other 20%. Medicare supplement plans can help pick up the extra 20%.
You may be asked to pay a copayment, deductible, refraction, or other fees at the time of service. For your convenience, we accept cash, checks, and most major credit cards. We appreciate your cooperation since we incur additional time and costs to bill and collect fees at a later date.
Never be afraid to ask questions!! If you are unclear about your coverage or benefits, contact your carrier’s Member Services.
Affordable Health Care Act—Questions and Enrollment
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