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Medicare
Supplements
Medicare
Gaps In Inpatient Hospital Coverage
In
2006 you pay:
- $952
deductible on first admission to hospital in each benefit
period.
- $238
daily coinsurance for days 61 through 90.
- All
charges for coverage after 90 days in benefit period unless
you have "lifetime reserve" days available and use them.
- $476
daily coinsurance for each lifetime reserve day used.
- For
the first three pints of whole blood or units of packed
cells used in each year in connection with covered services
unless the blood is replaced. To the extent the blood deductible
is met under one part of Medicare, it does not have to be
met under the other part.
- For
a private hospital room, unless medically necessary, and
for a private nurse.
- For
personal convenience items such as a telephone or television
in a hospital room.
- For
non-emergency care in a hospital that does not participate
in Medicare.
- For
care received outside the United States and its territories,
except under limited circumstances in Canada and Mexico.
Medicare
Gaps In Skilled Nursing Facility Coverage
In
2006 you pay:
- $119
daily coinsurance for days 21 through 100 in each benefit
period.
- All
costs after 100 days in a benefit period.
- All
costs for care that is less than the level of care Medicare
covers in a skilled nursing facility.
- All
costs if you were not transferred to the skilled nursing
facility in a timely manner after a qualifying hospital
stay.
- For
care in a general nursing home, or in a skilled nursing
facility not approved by Medicare, or for just custodial
care in a Medicare-approved skilled nursing facility.
- The
3-pint blood deductible (see lists of gaps under inpatient
hospital coverage)
Medicare
Gaps in Doctor and Medical Supplier Coverage
You
Pay:
- $124
annual deductible.
- Generally,
20% coinsurance and permissible charges in excess of Medicare
approved amount.
- 50%
of Medicare-approved amounts for most outpatient mental
health treatment.
- All
charges for most services that are not reasonable and necessary
for the diagnosis or treatment of an illness or injury.
- All
charges for routine physicals and other screening services,
except for periodic mammograms, pelvic examination (includes
Pap smear and clinical breast exam), PSA test and colorectal
cancer screening.
- All
charges for most dental care and dentures.
- All
charges for acupuncture treatment.
- All
charges for routine eye examinations or eyeglasses, except
prosthetic lenses after cataract surgery.
- All
charges for hearing aids or routine hearing loss examinations.
- All
charges for care outside the United States and its territories,
except in certain instances in Canada and Mexico.
- All
charges for routine foot care except when a medical condition
affecting the lower limbs (such as diabetes) requires care
by a medical professional.
- All
charges for services of naturopaths, Christian Science practitioners,
immediate relatives, or charges imposed by members of your
household.
- Unless
replaced, all charges for the first 3 pints of whole blood
or unit of packed cells used in each year in connection
with covered services. To the extent the 3-pint blood deductible
is met under Part A, it does not have to be met under Part
B.
- "Welcome
to medicare" physical examination. One time only within
the first 6 months that you have part "B" includes
measurement of height, weight and blood pressure. An EKG,
education and counseling.Diabetes services; screening tests,
fasting plasma glucose tests. Cardiovascular screening blood
tests: includes blood tests for cholesterol, lipid or triglyceride
levels, and other tests for cardeovascular disease.
Covering
Medicare's Gaps Next->
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