No, there are no excess charges for your Medicare Part A coverage (your hospital insurance). Excess charges only occur with Medicare Part B coverage (your physician insurance).
If you read a 2020 Medigap plan outline of coverage, you will see that Medicare Part A pays all but specified amounts during a hospital stay (as an inpatient) as follows:
- First 60 days – Medicare Part A pays for all but $1,408 (Part A deductible) – Medigap plans pay the deductible for you.
- Days 61-90 – Medicare Part A pays for all but $352 a day. Medigap plans pay the $352 a day for you (30 days totals up to $9,450).
- Days 91+ (while using 60 lifetime reserve days) – Medicare Part A pays for all but $704 a day. Medigap plans pay the $704 a day (60 reserve days totals up to $37,800).
- Once lifetime reserve days are used, additional 365 days – Medicare Part A pays $0. Medigap plans pay 100% of Medicare-eligible expenses up to an additional 365 days.
- Beyond the additional 365 days – Medicare Part A pays $0.
*Note – that’s per benefit period! A benefit period begins on the first day you receive services as an INPATIENT and ends after you’ve been out of the hospital for at least 60 days in a row. It’s possible to have more than one benefit period in the span of a year. Inpatient stay coverage per benefit period includes semi-private room and board, general nursing, and miscellaneous services and supplies. You can be in a hospital for a day or two and still be listed as an outpatient. If you’re unsure, you should ask your doctor if you’re listed as an inpatient or outpatient in their system.
Unless you’re admitted as an inpatient, you’re being treated as an outpatient which is where your Medicare Part B coverage comes into play. Medicare Part B pays about 80% of medical expenses leaving you responsible for the other 20% (Medigap plans cover all or a portion of the other 20%). If a doctor accepts Medicare assignment, they accept the Medicare-approved amount as payment in full. If they do not accept Medicare assignment, then they can bill you an excess charge – Medigap plan F and plan G cover excess charges.
If you need help getting your Medigap plan set up or have any other questions, give us a call today at 1-888-972-0024 to speak with a live agent or click here to e-mail us. Even if you already have a plan in place, we can check to see if another carrier can offer the same plan at a lower price to save you money! Medigap plans are standardized so why pay more than you have to for the same coverage?
Call now and start saving today!