** Cost ** |
Premium and Other Important Information |
Balance billing means that a provider may charge and bill you more than the plan’s payment amount for services There is a limit on what providers may charge for Medicare-covered services |
You will not have a monthly plan premium. Medicare pays the monthly plan premium for the Medicare MSA Plan. |
Most people will pay the standard monthly Part B premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more information about Part B premiums based on income call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. You may also call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. |
Balance billing counts towards your plan deductible. |
$3 000 annual deductible |
Note that only Medicare-covered services will count toward your annual deductible. |
Medicare will deposit $1 500 into your bank account. |
** Extra Benefits ** |
Over-the-Counter Items |
The plan does not cover Over-the-Counter items. |
Transportation |
This plan does not cover supplemental routine transportation. |
** Important Information ** |
Premium and Other Important Information |
Balance billing means that a provider may charge and bill you more than the plan’s payment amount for services There is a limit on what providers may charge for Medicare-covered services |
You will not have a monthly plan premium. Medicare pays the monthly plan premium for the Medicare MSA Plan. |
Most people will pay the standard monthly Part B premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more information about Part B premiums based on income call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. You may also call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. |
Balance billing counts towards your plan deductible. |
$3 000 annual deductible |
Note that only Medicare-covered services will count toward your annual deductible. |
Medicare will deposit $1 500 into your bank account. |
** Inpatient Care ** |
Inpatient Hospital Care |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Inpatient Mental Health Care |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Skilled Nursing Facility (SNF) |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Home Health Care |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Hospice |
You must get care from a Medicare-certified hospice. Your plan will pay for a consultative visit before you select hospice. |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
** Outpatient Care ** |
Doctor Office Visits |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Chiropractic Services |
Medicare-covered chiropractic visits are for manual manipulation of the spine to correct subluxation (a displacement or misalignment of a joint or body part) if you get it from a chiropractor. |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Podiatry Services |
Medicare-covered podiatry visits are for medically-necessary foot care. |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Outpatient Mental Health Care |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Outpatient Substance Abuse Care |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Outpatient Services |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Ambulance Services |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Emergency Care |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Urgently Needed Care |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Outpatient Rehabilitation Services |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
** Outpatient Medical Services and Supplies ** |
Durable Medical Equipment |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Prosthetic Devices |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Diabetes Programs and Supplies |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Diagnostic Tests, X-Rays, Lab Services, and Radiology Services |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
** Preventive Services ** |
Cardiac and Pulmonary Rehabilitation Services |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Preventive Services and Wellness/Education Programs |
This plan does not cover supplemental education/wellness programs. |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Kidney Disease and Conditions |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Outpatient Prescription Drugs |
Most drugs not covered. |
This plan does not offer prescription drug coverage. |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Dental Services |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Hearing Services |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
** Additional Benefits ** |
Vision Services |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Over-the-Counter Items |
The plan does not cover Over-the-Counter items. |
Transportation |
This plan does not cover supplemental routine transportation. |
Acupuncture |
This plan does not cover Acupuncture. |
** Inpatient Care ** |
Inpatient Hospital Care |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
** Outpatient Care ** |
Doctor Office Visits |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Outpatient Services |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Ambulance Services |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
** Outpatient Medical Services and Supplies ** |
Durable Medical Equipment |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
Diagnostic Tests, X-Rays, Lab Services, and Radiology Services |
Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met. |
** Additional Benefits ** |
Over-the-Counter Items |
The plan does not cover Over-the-Counter items. |
Transportation |
This plan does not cover supplemental routine transportation. |