Patients with Medi-Cal or Medicare
If you are
currently uninsured, you may qualify for Medi-Cal or Medicare coverage.
Facts about Medi-Cal
Medi-Cal is an
insurance program jointly funded by your state and federal government. Patients
have 90 days from date of treatment to apply for Medi-Cal; this applies to
inpatient and outpatient treatment.
Eligibility is determined by:
- Disability due to medical reasons
- Number of minor children (under the age of 18) in the home
- Inability to return to work for four months or more
For more info
or contact the Patient Financial Services department at
Medicare is a
federally funded health insurance program for people age 65 or older, some
people with disabilities under age 65, and people with End-Stage Renal Disease.
Medicare has 2 parts, Part A and Part B. Part A is hospital insurance - most
people do not pay for Part A coverage. Part B is medical insurance - most
people pay monthly for Part B coverage.
There are limitations on a number of services and items covered by Medicare and
Medi-Cal, depending on the plan you have. You are responsible for co-payments,
deductibles, and other services not covered.
Premiums and Deductibles/Co-payments (2012 Rates)
Deductible and Coinsurance Amounts for 2012:
(pays for inpatient hospital,
skilled nursing facility, and some home health care) For each benefit period
Medicare pays all covered costs except the Medicare Part A deductible (2012 =
$1,156) during the first 60 days and coinsurance amounts for hospital stays
that last beyond 60 days and no more than 150 days.
each benefit period you pay:
- A total of $1,156 for a hospital
stay of 1-60 days.
- $289 per day for days 61-90 of a
- $578 per day for days 91-150 of a
hospital stay (Lifetime Reserve Days).
All costs for each day beyond 150
Nursing Facility Coinsurance
- $144.50 per day for days 21 through
100 each benefit period.
(covers Medicare eligible physician
services, outpatient hospital services, certain home health services, durable
- $140.00 per year. (Note: You pay
20% of the Medicare-approved amount for services after you meet the $140.00
information about the Medicare premiums, deductibles, and coinsurance rates for
2012 is available in the October 27, 2011 Fact Sheet titled, "Medicare Premiums and Deductibles for 2012
" on the www.cms.gov