Medicare deductibles and coinsurance for CY 2010
Patient Access Weekly Advisor, December 2, 2009
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The following article is an excerpt from HCPro’s resource for hospital case managers—www.CaseManagementMentor.com—a free blog dedicated to connecting hospital case managers to industry pacesetters, peers, and best practices.
CMS recently published the Part A deductible and coinsurance and Part B deductible amounts for CY 2010. For most covered inpatient stays, as well as covered outpatient services, Medicare does not pay the entire Medicare allowable for those stays or outpatient services. Beneficiaries generally are responsible for a portion of the Medicare allowable in the form of deductibles and/or coinsurance.
Under Part A, Medicare beneficiaries are entitled to 90 regular benefit days per benefit period. Regular benefit days renew whenever a new benefit period begins. That is, a patient once again has 90 covered inpatient days every time a new benefit period begins. Medicare beneficiaries are also entitled to 60 lifetime reserve days, which may be used after regular benefit days for that benefit period have been exhausted. Lifetime reserve days do not renew. Once used, they are gone forever.
A benefit period begins with the first day on which a patient is admitted to an inpatient hospital or a SNF to receive services. That benefit period continues until there is a 60-consecutive-day period during which the patient is not an inpatient in either a hospital or a SNF. (With respect to the latter, the benefit period does not close as long as the patient is receiving skilled care as an inpatient in the SNF.)
Browse more blog posts at www.CaseManagementMentor.com.
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