If most of your healthcare dollars go toward hospital stays, you primarily take generic drugs and/or you live on a limited income, the Care Basic Plan may work best for you. The Care Basic Plan does not cover Medicare Part B services but provides coverage for Medicare Part A services (hospital stays). The monthly rate is more affordable, and prescription drug benefits are included in the plan with copays for generic and brand name preferred and non-preferred medications (the standard Medicare coverage gap applies).
2012 Monthly rate: $118.00
(per person, per month)
Part A Services
(as defined by Medicare) |
Medicare Pays |
Care Basic Plan Pays |
You Pay1 |
Hospital stays:
Semi-private room and board, general nursing and other hospital services and supplies |
- 100% days 1-60
- Costs over $289 a day for days 61-90
- Costs over $578 a day for days 91-150 (lifetime reserve days)
|
- 50% of the Part A deductible (for every benefit period)2
- $289/day for days 61-90
- $578/day for days 90-150 (lifetime reserve days); 100% after reserves are depleted
- All costs after 150 days
|
$578
(50% of the Part A deductible) 2 |
| Skilled nursing facility care |
- 100% days 1-20
- Costs over $144.50 a day for days 21-100
|
Not a covered benefit |
- $144.50/day for days 21-100
- 100% after 100 days
|
Part B Services
(as defined by Medicare) |
Medicare Pays |
Care Basic Plan Pays |
You Pay1 |
Preventive care*
(for recommended preventive care services, including an annual wellness visit) |
100% |
Nothing |
Nothing |
Medical services and supplies:
Doctors' services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment and other services |
80% of Medicare-approved amounts for covered services |
Not a covered benefit |
- $140 (Part B deductible)3
- Remaining 20% of Medicare-approved amounts
|
| Outpatient mental health services |
55% of Medicare-approved amounts for covered services |
Not a covered benefit |
Remaining 45% of Medicare-approved amounts for covered services |
| Diagnostic clinical laboratory service |
100% of Medicare-approved amounts for covered services |
Not a covered benefit |
Costs above Medicare-approved amounts or services not covered by Medicare |
*For those enrolled in Medicare Part B, Medicare pays 100% of costs for recommended preventive care services (including an annual wellness visit), per Your Guide to Medicare Preventive Services. You may find a copy of this guide on Medicare's website.
1 You are responsible for 100% of any charges not covered by Medicare or that are above the Medicare-approved amount.
2 You must pay 50% of the Part A deductible for every benefit period, which begins when you are admitted and ends when you have not received hospital or skilled nursing facility treatment for 60 days in a row.
3 You pay the Part B deductible once a year.