Definition of "Medicare catastrophic coverage act"
Federal legislation passed in 1988 (repealed November 23, 1989) that significantly increased the benefit amounts provided under medicare, both Part A and Part B, in the following manner:
- Doctors' bills effective January 1, 1990. Medicare patients under Part B would have had their out-of-pocket expenses for doctors' bills limited to $1370. However, if the doctor charged more than Medicare approved, the patient would be liable for the difference.The patient would have paid the first $75 as a DEDUCTIBLE for the approved charges, and Medicare would have paid 80% of the remaining approved charges up to $1370, and 100% of the approved charges above $1370. Any payments made by the patient's private insurance would be applied to the $1370.
- Hospital bills effective January 1,1990, Medicare patients would have paid a deductible of $564 per year for the first stay in the hospital. After this deductible was paid, Medicare would have paid 100% of all hospital bills regardless of the length of stay.
- Drugs effective January 1,1990, Medicare would have begun paying for OUTPATIENT prescription drugs. After the patient paid a $550deductible, Medicare would have paid 80% of the cost of intravenous drugs, to include antibiotics, and 50% of the cost of immunosuppressive drugs. Effective January 1, 1991, after the patient paid a $600 deductible and a 50% CO PAYMENT, Medicare would have paid for most other prescription drugs and insulin. Effective January 1, 1992, after the patient paid a $652 deductible and a 40% co payment,most prescription drugs would have been covered by Medicare. Effective January 1, 1993, and beyond, after the patient paid a deductible yet to be determined and a 20% co payment, most prescription drugs would have been covered by Medicare.
- Skilled nursing facility effective January 1,1989, after the patient paid a co payment of $22 per day for the first eight days, Medicare would have paid for 150 days of skilled nursing facility care.
- Home health care effective January 1, 1990, patients who did not require daily care would have been eligible for up to six days a week of home health care for as long as the doctor prescribed.
- Hospice care effective January 1, 1989, terminal patients would have been entitled under Medicare to unlimited hospice care.
- Respite care effective January 1, 1990, an individual who was caring for a Medicare patient (provided the patient had met either the $1370 Part B limit or the annual deductible for prescription drugs) at home who required daily care would have been entitled to80 hours per year of home health aide and personal care services.
- Mammography effective January 1, 1990, a Medicare patient would have been covered up to $50 for X-ray expenses incurred to detect breast cancer. The costs to Medicare participants would have been as follows: Currently, all Medicare Part B beneficiaries must pay an extra $4 premium each month above the normal Medicare Part A premium. By 1993, the extra premium would have been $10.20 per month. All individuals who were entitled to Part A benefits for more than six months during a tax year and owed at least $150 in federal income taxes would also have paid a supplemental premium of 15% for each $150 for 1989,25% for 1990,26% for 1991,27% for 1992, and 28% for 1993. For tax years starting after 1993, the annual limit would have been tied to increases in the costs of Medicare. The maximum supplemental premium would have been $800 per Medicare beneficiary, or $1600 per couple enrolled in Medicare for tax year 1989; $850 and $1700, respectively, for tax year 1990; $900 and $1800, respectively, for tax year 1991; $950 and $1900, respectively, for tax year 1992; and $1050 and $2100, respectively, for tax year 1993.
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