Medicare Part A Benefits
 

	In 2007 You Will Pay
Monthly Premium	Nothing (if you or your spouse have worked for 10 years or more)
	$226 (if you or your spouse worked between 7.5 and 10 years)
	$410 (if you or your spouse worked less than 7.5 years)
Inpatient Hospital	$992 deductible per benefit period
	No coinsurance for days 1-60
	$248 daily coinsurance for days 61-90
	$496 daily coinsurance for 60 lifetime reserve days
Skilled Nursing Facility	No deductible for each benefit period
	No coinsurance for days 1-20
	$124 daily coinsurance 21-100
Home Health Care	No deductible or coinsurance
Hospice Care	No deductible
	Small copayment for outpatient drugs and inpatient respite care

Medicare Part B Benefits
 

	In 2007 You Will Pay . . .
Monthly Premium	$93.50 if your annual income is below $80,000 ($160,000 for couples). If your income is higher, your premium will be higher.
Annual Deductible	$131
Doctor and other medical services	20% 1
Outpatient hospital care	Coinsurance or Copayment 2
Home health care	Nothing
Clinical diagnostic lab services	Nothing
Other diagnostic tests and x-rays 4	20%
Diabetes self-management supplies (glucose monitors, lancets, test strips)	20%
Durable medical equipment (e.g., wheelchairs, hospital beds)	20% 4
Physical therapy services5	20%
Ambulance services	20%
Chiropractor services	20%
Outpatient mental health services	50%
Blood	20% after first three pints per year.
1 Of Medicare approved amount for providers who accept assignment. If your doctor does not accept assignment, federal law allows him or her to charge up to 15% above Medicare’s approved amount. Some state laws offer more protection. 2 Based on diagnosis 3 Copies of x-rays are not covered. 4 Of Medicare approved amount for DME suppliers who accept assignment. For DME suppliers who do not accept assignment, Medicare does not limit how much they can charge above Medicare’s approved amount. Medigap plans F, G, I, and J that cover DME will not cover anything above the Medicare approved amount. 5 As of January 1, 2006, Medicare limits how much it will pay for outpatient physical therapy (PT), speech-language pathology (SLP) and occupational therapy (OT). The limits for 2007 are $1,780 per calendar year for PT and SLP combined and an additional $1,780 per calendar year for OT. After you pay the Part B deductible, Medicare will cover 80 percent of the limit ($1,424). After the limit has been reached, you will pay the full cost of the services until January 1st of the following year.

Medicare Part D Benefits
 

	In 2007 You Will Pay
Monthly Premium	Varies by plan. Average national premium is $27.35
Annual Deductible	Varies by plan. Cannot be more than $265 if you do not have Extra Help. $0 if you have Full Extra Help. $53 if you have Partial Extra Help
Coinsurance/ Copayments If You Do Not Have Extra Help	Varies by plan and by drug within plan. After spending a pre-determined amount in total drug costs (usually $2,400), you may have to pay 100% of the cost of your drugs until coverage begins again (coverage gap). In all plans, after you have spent $3,850 out of pocket (not including premium or the costs of drugs not on your plan's list of covered drugs or that you bought in a pharmacy outside the plan's network), you will pay 5%, or $2.15 for generics and $5.35 for brand-name drugs (whichever is higher) of the cost of each drug (catastrophic coverage).
Coinsurance/ Copayments If You Have Extra Help	If you have Medicaid and your income is below 100% if the Federal Poverty Level ($9,800 a year in 2006 for individuals and $13,200 a year for couples): $1 for generics and $3.10 for brand-name drugs. After your total drug costs reach $5,451.25, you will get catastrophic coverage and pay $0 for each drug for the rest of the calendar year. If you have Full Extra Help: $2.15 for generics and $5.35 for brand-name drugs. After your total drug costs reach $5,451.25, you will get catastrophic coverage and pay $0 for each drug for the rest of the calendar year. If you have Partial Extra Help: 15% of each prescription. After your total drug costs reach $5,451.25, you will get catastrophic coverage and pay $2.15 for generics and $5.35 for brand-name drugs for the rest of the calendar year.

 

Medicare does not cover the following services (you must pay the full cost yourself):

• Acupuncture

• Dental care

• Care outside of the United States

• Chiropractic services (except to correct a subluxation--when one or more of the bones of your spine moves out of position--using manipulation of the spine)

• Cosmetic surgery

• Custodial care (unless skilled nursing care is provided)

• Eyeglasses (except after cataract surgery)

• Hearing aids (except certain implants for extreme hearing loss)

• Long-term care

• Personal Care

• Private duty nursing