Medicare Catastrophic Coverage Act

Definition of "Medicare catastrophic coverage act"

Written by

Jodi Bakst, Broker

Real Estate Experts

Federal legislation passed in 1988 (repealed November 23, 1989) that significantly increased the benefit amounts provided under medicare, both Part A and Part B, in the following manner:

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. Hospice care effective January 1, 1989, terminal patients would have been entitled under Medicare to unlimited hospice care.
7. 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.
8. 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.