Medicare cost sharing includes deductibles; which statement is correct?

Medicare cost sharing includes deductibles; which statement is correct?

• A. Deductibles require reaching a predetermined amount of personal expenditure each 12-month period before Medicare payment is activated
• B. Deductibles are paid after every service
• C. Deductibles do not apply to Medicare
• D. Deductibles cap annual charges

Answer: (A)

Medicare cost sharing hinges on a deductible you must meet before Medicare begins to pay. In Part B, this is an annual calendar-year deductible you must satisfy before Medicare covers its share of most services. In Part A, there’s a deductible per benefit period for inpatient hospital stays, and you pay that amount each time a new benefit period starts. Once the deductible is met, Medicare pays its portion according to the plan, with you responsible for the remaining coinsurance or copays. This makes the statement that the deductible requires reaching a predetermined amount of your own spending in a defined period before Medicare payments start the best description of how cost sharing works. The other ideas don’t fit: deductibles are not paid after every service; deductibles do apply to Medicare; and deductibles do not cap annual charges.

Medicare cost sharing hinges on a deductible you must meet before Medicare begins to pay. In Part B, this is an annual calendar-year deductible you must satisfy before Medicare covers its share of most services. In Part A, there’s a deductible per benefit period for inpatient hospital stays, and you pay that amount each time a new benefit period starts. Once the deductible is met, Medicare pays its portion according to the plan, with you responsible for the remaining coinsurance or copays.

This makes the statement that the deductible requires reaching a predetermined amount of your own spending in a defined period before Medicare payments start the best description of how cost sharing works. The other ideas don’t fit: deductibles are not paid after every service; deductibles do apply to Medicare; and deductibles do not cap annual charges.