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Insurance > Medicare Supplement Insurance > Medicare Coverage
Medicare Coverage

What doesn't Medicare cover?
When Medicare was established in 1965, it was expected to pay 80 percent of health-care costs for individuals age 65 and older. From 1998 to 2003, the rate of medical care inflation was higher than the preceding year1, and about 14 cents of every health care dollar comes from your pocket for medical care.2

When Medicare doesn't pay all of the cost of a service there is a gap in coverage. For example, Medicare deductibles and coinsurance are cost-sharing gaps. Other gaps occur when you have to pay for services Medicare doesn't cover.

The amounts Medicare pays for covered services are based on Medicare-approved charges. Here is an example which assumes the Part B deductible has been met:

Surgeon's charge: Medicare-approved charge: Medicare pays 80 percent: Patient pays:
$1,150* $1,000 $800 $350
or
$200 if surgeon accepts assignment

Here are some items Medicare does not cover: 3

  • Generally, 20 percent of Medicare-approved charges for inpatient or outpatient physician and surgical services, physical and speech therapy and diagnostic tests.
  • The per day co-insurance for inpatient hospital stays, days 61-150 and all costs beyond 150 days.
  • The first three pints of blood.
  • The Part A deductible for inpatient hospital stays.
  • The per-day coinsurance for skilled nursing facility care from day 21 through day 100, and all costs beyond day 100.
  • Emergency care in a foreign country.
  • The Part B deductible for medical services.
  • Excess charges.
  • The cost of prescription drugs, unless they are received as part of inpatient care.

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20519WC R11-05


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Appleton Office:
4321 N. Ballard Road
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625 Fourth Avenue S.
Minneapolis, MN 55415-1624 USA
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Thrivent Financial for Lutherans, Appleton, WI 54919-0001, is authorized to conduct business in all 50 states and the District of Columbia. NAIC # 2938-56014. Products issued by Thrivent Financial for Lutherans are available to applicants who meet membership, insurability, U.S. citizenship and residency requirements. Not all products described are available in all states. Thrivent Financial representatives are licensed insurance agents. Insurance and retirement products, where available, are individual contracts, (not group coverage), and issued by Thrivent Financial for Lutherans. Investment products are offered through Thrivent Investment Management Inc., 625 Fourth Ave. S., Minneapolis, MN 55415-1665, a wholly owned subsidiary of Thrivent Financial for Lutherans. Member FINRA. Member SIPC. Thrivent Financial representatives are registered representatives of Thrivent Investment Management Inc.

Bank products and trust services are offered through Thrivent Financial Bank, 2000 E. Milestone Dr., Appleton, WI 54919-0006 (Member FDIC, Equal Housing Lender), a wholly owned subsidiary of Thrivent Financial for Lutherans. Insurance, investment products, securities, trust, and investment management services and accounts are not deposits, are not FDIC insured, are not insured by any federal government agency, and are not guaranteed by Thrivent Financial Bank. Variable insurance contracts, investment products, trust, and investment management accounts may go down in value.

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This document was last updated on Monday, July 23, 2007 at 1:07 PM