Deductible
The initial amount of covered expenses the insured must pay each benefit period before the insurer begins paying. Its purpose is to eliminate small claims and reduce premium.
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Practice This Concept
Within a Medicare Part A benefit period, for the first 60 days of inpatient hospitalization, the beneficiary:
Pays no daily coinsurance for days 1-60 after satisfying the Part A inpatient deductible — Within a benefit period, Medicare Part A covers inpatient hospital care with no daily coinsurance for days 1 through 60, after the beneficiary pays the Part A inpatient deductible. Daily coinsurance applies starting with days 61-90, and the lifetime reserve days beyond day 90 carry an even higher daily copay. This front-loaded coverage means the first 60 days are the most fully paid portion of a hospital stay, apart from the deductible. The benefit-period structure drives Part A hospital cost sharing: one deductible per benefit period, no daily coinsurance for days 1 through 60, coinsurance for days 61 through 90, and coinsurance for the 60 lifetime reserve days available after day 90. A new benefit period begins only after 60 consecutive days out of a hospital or skilled nursing facility.
National insurance concept
Which medical savings arrangement under federal law is available only to self-employed individuals and employees of small employers, and requires coverage under a high-deductible health plan?
Archer Medical Savings Account (MSA) — An Archer Medical Savings Account (MSA) is a federal tax-advantaged account created before HSAs. It is available only to self-employed individuals and employees of small employers, and it must be paired with a high-deductible health plan. Coverage under an Archer MSA is much more limited than an HSA, which is open to anyone enrolled in a qualifying high-deductible health plan regardless of employment size. Because eligibility is restricted by law, the Archer MSA is the correct answer when a question asks which arrangement is limited to self-employed persons and small employers.
National insurance concept
- Medical ExpenseWithin a Medicare Part A benefit period, for the first 60 days of inpatient hospitaliza…
- Medical ExpenseWhich medical savings arrangement under federal law is available only to self-employed …
- Medical ExpenseWhich statement correctly describes a high-deductible health plan (HDHP)?
- Medical ExpenseAn individual medical expense policy that pays the insured the actual covered charges i…
- Medical ExpenseA high-deductible health plan (HDHP) eligible to pair with an HSA generally provides:
- Medical ExpenseWithin a Medicare benefit period, for inpatient hospital days 61 through 90 after the d…
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