Question:
What is the 20% cost estimated after medicare pays for surgery?
I am 30 and disabled. I have Medicare only. I was wanting to know from someone who has had the surgery and only had medicare of what the left over cost were. — Rita W. (posted on June 21, 2002)
June 21, 2002
My understanding of how Medicare works is this:
They pay 80% of the Medicare amount for services, leaving you responsible
for 20%. Let's say that the actual cost of your surgery was $40,000 and of
that amount Medicare "approved" $30,000, they would pay 80% of
the $30,000 and if the provider is contracted with Medicare, they would
write off the balance. Medicare bases their approved amounts on Reasonable
& Customary charges for a specific area. It may be worth checking with
your Medicare provider to see if they have any information for you. Good
luck!
— Rosario T.
June 21, 2002
Ooops, I meant to say that you would be responsible for 20% of the approved
amount, not 20% of the actual charge. Sorry about that!
— Rosario T.
June 21, 2002
If you have Medicare and you are inpatient for this surgery your bills will
be broken down into the dr fees (part B) and the hospital fees (part A).
The Dr services involved will be paid by Medicare at 80% of the allowed
amount and you will be resp for 20% of the allowed amount. You will owe the
hospital $812 for the inpatient deductible. Medicare does not pre approve
ANY services. It is totally based on Medical neccesity.
— Dawn E.
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