Last page edit 04/17/08

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Medicare Benefits - 2007 (Part A and Part B)

Medicare Hospital Insurance (Part A)      Medicare Medical (Part B)        Items Not Covered       Medicare Advantage (Part C)

More Information on Medicare Premiums and Deductibles

Deductible $1,024 Per benefit period.
Coinsurance $1,024 Per spell of illness plus
$256 Per day for the 61st through the 90th day, per benefit period.
$512 Per day for the 91st through the 150th day, (lifetime reserve days).
Skilled Nursing Facility Coinsurance $0 Per day for the 1st through the 20th day, per benefit period.
$128 Per day for the 21st through the 100th day, per benefit period.
Hospital Insurance Premium $423  Per month. (If you have 29 or fewer quarters of Social Security Coverage)
Reduced Hospital Premium $233  Per month. (If you have 30-39 quarters of Social Security Coverage)

When do these numbers change?

Medicare Medical Insurance (Part B)

Annual Deductible $135
Monthly Premium $96.50
Doctor and other medical services 20% 1
Outpatient hospital care Coinsurance or Copayment 2
Home health care 20%
Clinical diagnostic lab services 20%
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 services 20%
Ambulance services 20%
Chiropractor services 20%
Outpatient mental health services 50%
Blood 20% after first three pints per year.
When do these numbers change?

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 Durable Medical Equiptment (DME) suppliers who accept assignment. For DME suppliers who do 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.

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

  • Private duty nursing
  • Custodial care, unless skilled nursing care is provided at the same time
  • Most chiropractic services
  • Cosmetic surgery
  • Care outside of the United States
  • Acupuncture
  • Eyeglasses, except after cataract surgery
  • Dental care                                                                                                                                            

 
Source: Maryland Legal Assistance Network (MLAN), updated by the Maryland State Law Library (MSLL).

Date of Last legal review 4/17/08 (PLL/M.A.J.)
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About this website. The Maryland State Law Library, a court-related agency of the Maryland Judiciary, sponsors this site. The website was developed (1999-2007) as part of an access to justice initiative by the Maryland Legal Assistance Network (MLAN) in collaboration with a number of legal services providers serving low and moderate income Marylanders.  In the absence of file-specific attribution or copyright, the Maryland State Law Library may hold the copyright to parts of this website. You are free to copy the information for your own use or for other non-commercial purposes with the following language “Source: Maryland's People’s Law Library – www.peoples-law.org. © Maryland State Law Library, 2007.”

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