Licensed Independent Agent, Texas Insurance Alliance, Little Elm, TX
Original Medicare part A:
$1,316 deductible for each benefit period.
Days 1–60: $0 coinsurance for each benefit period.
Days 61–90: $329 coinsurance per day of each benefit period.
Days 91 and beyond: $658 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).
Beyond lifetime reserve days: all costs.
Original Medicare part b:
You pay $183 per year for your Part B deductible. After your deductible is met, you typically pay 20% of the Medicare-approved amount for these:
Most doctor services (including most doctor services while you're a hospital inpatient)
Outpatient therapy
Durable medical equipment
Medicaid varies for each state. In Texas (the state I reside), if someone 65+ has Medicare & full Medicaid, the Medicaid picks up 100% of the remaining out of pocket costs for covered services as well as 100% of prescription costs. Original Medicare does not cover prescriptions.
If someone has both Medicare & Medicaid, I highly recommend looking at an Advantage Dual special needs plan through an insurance company. They will get their full health benefits and typically the insurance companies add additional benefits like vision/dental/etc. that are typically not offered by Medicaid. Let me know if I can show you some options!
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$1,316 deductible for each benefit period.
Days 1–60: $0 coinsurance for each benefit period.
Days 61–90: $329 coinsurance per day of each benefit period.
Days 91 and beyond: $658 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).
Beyond lifetime reserve days: all costs.
Original Medicare part b:
You pay $183 per year for your Part B deductible. After your deductible is met, you typically pay 20% of the Medicare-approved amount for these:
Most doctor services (including most doctor services while you're a hospital inpatient)
Outpatient therapy
Durable medical equipment
Medicaid varies for each state. In Texas (the state I reside), if someone 65+ has Medicare & full Medicaid, the Medicaid picks up 100% of the remaining out of pocket costs for covered services as well as 100% of prescription costs. Original Medicare does not cover prescriptions.
If someone has both Medicare & Medicaid, I highly recommend looking at an Advantage Dual special needs plan through an insurance company. They will get their full health benefits and typically the insurance companies add additional benefits like vision/dental/etc. that are typically not offered by Medicaid. Let me know if I can show you some options!