Southwest General Hospital

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Medicare Policies

Billing Medicare
 

Southwest General Health Center will bill Medicare for inpatient and outpatient services. Supplemental insurance also will be billed, at the patient's request.

There are some items that are excluded from Medicare coverage such as drugs that can be self-administered in an outpatient setting. These include most oral drugs given in the Emergency Department, treatment areas, or observation. Your Medicare handbook is a good reference for this information. You can obtain one by calling 1-800-MEDICARE (800-633-4227).

Medicare Deductible and Coinsurance Amounts for 2016:
 

Part A Inpatient Deductible: (pays for inpatient hospital, skilled nursing facility, and some home health care)

 

Days 1 - 60 $ 1,288.00
Days 61 - 90 $ 322.00 per day
Days 91 - 150 $ 644.00 per day (Lifetime Reserve Days)
All costs for each day beyond 150 days
Note: You have 60 Lifetime Reserve Days available at day 91


Part B Outpatient Deductible: (covers Medicare-eligible physician services, outpatient hospital services, certain home health services, durable medical equipment)

$166.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $166.00 deductible.)

Skilled Nursing Facility Co-insurance

Days 1 - 20 Medicare Covers
Days 21 - 100 $ 161.00 per day


In addition to your deductible, you may be liable for co-insurance.

Additional information regarding Medicare can be found on the Medicare Frequently Asked Questions page.