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[IP] Re: Medicare and pump rental



 Yes, you are correct, Phyllis. Simple example: doctor charges $200, Medicare
approves $100 as the allowed amount. Medicare pays $80, you pay $20 coinsurance,
assuming you don't have a supplement. Before you pay the 20% coinsurance however
you have to meet the $147 annual deductible. The above is for most Part B
covered expenses that are approved by Medicare. Some things like labs and home
health care don't have the 20% coinsurance. That's also if the doctor accepts
assignment. If they don't, they're allowed to bill you an extra 15% above the
Medicare approved amount, so in this example another $15, meaning you would pay
$35 total. Some Medigap supplement plans cover these "excess" charges (e.g.,
Medigap Plan F), others don't. All of the above pertains to Original Medicare.
If you've assigned your Medicare benefits over to a Medicare Advantage plan,
then it's a whole different ballgame. Each MA plan can have it's own rules about
deductibles and copays. Pam
------------------------------

Date: Thu, 19 Dec 2013 09:24:32 -0500
From: PHYLLIS ABRAM <email @ redacted>
Subject: Re: [IP] Re: Medicare and pump rental

Sent from my iPhone
Phyllis 

> On Dec 19, 2013, at 3:40 AM, Stacey Martin <email @ redacted> wrote:
> 
> Of course that 20% is 20% of the Medicare approved amount, not the amount the
> supplier or doctor charges. There's usually a considerable difference between
> the two.
.
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