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Medicare 2008 Benefits Table

2008 Medicare Benefits Table

Summary of Traditional Medicare, 2008

PART A

Financing:
1.45% for both workers and employers
No premiums* Benefits: Inpatient hospital
– Days 1-60
– Days 61-90
– Days 91-150
– After 150 days Deductible of $1,024 per benefit period**
No coinsurance
$256 a day
$512 a day
No benefits Skilled nursing facility
– Days 1-20
– Days 21-100
– After 100 days
No coinsurance
$128 a day
No benefits Home health No coinsurance Hospice Copayment of up to $5 for outpatient drugs and 5% coinsurance for inpatient respite care

Part B

Financing:
Premiums cover about 25% of Part B costs ($96.40 per month usually deducted from Social Security checks). General revenues cover the remaining 75%. Benefits: Deductible $135 a year Physician and other medical services
– MD accepts assignment
– MD does not accept assignment
20% coinsurance
20% coinsurance plus up to 15% over Medicare-approved fee Outpatient hospital care 20% coinsurance Ambulatory surgical services 20% coinsurance X-rays 20% coinsurance Durable medical equipment 20% coinsurance Physical, occupational, and speech therapy 20% coinsurance*** Clinical diagnostic laboratory services No coinsurance Home health care No coinsurance Outpatient mental health services 50% coinsurance Preventive services
– Flu shots, pneumococcal vaccines, colorectal and prostate cancer screenings; pap smears;
mammograms
– Bone mass measurement, diabetes monitoring; glaucoma screening
The Part B deductible and 20% coinsurance are waived for certain preventive services.

20% coinsurance after deductible is met

Part D

Information below applies to the standard Part D benefit design in 2008. Benefits and cost-sharing requirements typically vary across plans. Beneficiaries receiving low-income subsidies pay reduced cost-sharing amounts. Deductible $275 a year Initial Coverage (up to $2,510 in drug costs)
25% coinsurance
Coverage Gap or “doughnut hole”
100% coinsurance (no coverage)
Catastrophic Coverage (above $4,050 in out-of-pocket costs)
5% coinsurance * People age 65 and older are automatically entitled to Medicare if they (or their spouse) worked for 40 quarters or more.
Those who have worked up to 30 quarters may be able to get Part A coverage by paying a premium of $423 per month (2008).
**A benefit period begins when a person is admitted to a hospital and ends 60 days after discharge from a hospital or a skilled nursing facility.
*** Coverage limit on Medicare outpatient therapy services ($1,740 limit per year for occupational therapy services, $1,740 limit per year for physical and speech-language therapy services combined).
Note: For more detailed information on preventive and other benefits, see http://www.Medicare.gov.
SOURCE: Centers for Medicare and Medicaid Services (CMS), “Medicare and You, 2008”.