Medicare, Medicaid, Life and Health Insurance/Medicare Part A deductable


QUESTION: My mother was just admitted to the hospital, she's 88. They are keeping her there overnight,(maybe longer). She has water in the lungs, slight fever. My question is on Medicare Part A deductible. According to the 2013 deductible list:  
"Hospital Stay
In 2013, you pay
$1,184 deductible per benefit period
$0 for the first 60 days of each benefit period"

$296 per day for days 6190 of each benefit period

Does this mean she will not pay anything for her stay? In the past the deductible started on day 1, now it appears it does not start until day 61.

ANSWER: Does your mother have Original Medicare and a Medigap policy or does she have a Medicare Advantage Plan?

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QUESTION: She has Original Medicare (started around 1991), but also a Medicare F+ (Medigap coverage). Her deductible for her Medigap coverage is around $2300.

ANSWER: She will have to pay the medigap deductible before the Medigap coverage will pick up the hospitalization deductible. I wonder why she has this plan. The F plan without the plus would have covered it all.

---------- FOLLOW-UP ----------

QUESTION: The F+ plan is $129 a month, the F plan is $372. The F+ plan saves her $2916 a year.  (372 - 129 = 243.  243 * 12 = $2916). The F+ deductible is $2110. My mother has no major health problems, sees her doctor every 2 months.

Benefit period
The way that Original Medicare measures your use of hospital and skilled nursing facility (SNF) services. A benefit period begins the day you're admitted as an inpatient in a hospital or SNF. The benefit period ends when you haven't received any inpatient hospital care (or skilled care in a SNF) for 60 days in a row. If you go into a hospital or a SNF after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There's no limit to the number of benefit periods.

Medicare, Medicaid, Life and Health Insurance

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Merry Schiff


I am very familar with Medicare and general insurance questions. I can answer general questions about HMO's.


I have been in the medical billing industry for 50 years. I have helped develop software for this industry. I am a consultant to billers and the medical profession.

I am the Executive Director of NEBA, a medical billing organization with nearly 1000 members.

I have been teaching medical billing for many years as well as being a published author with Pearson Education. One book on medical billing (nearly 800 pages) and one on HIPAA.

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