Medicare Deductibles & Coinsurance

​Part A (Hospital Insurance)

Hospital or skilled nursing facility costs per benefit period are listed below. The benefit period begins the day you enter the hospital or skilled nursing facility and ends when you haven’t received any inpatient care for 60 consecutive days.

Hospital Care:
$1,316 deductible per benefit period
​Days 1 - 60
​$0 coinsurance for each benefit period in 2018
​Days 61 - 90
​$335 coinsurance per day of each benefit period in 2018
​Days 91 and beyond
​$670 coinsurance per each :lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime).

Beyond lifetime reserves days: all costs are your responsibility

Skilled Nursing Facility Care (SNF)
​Days 1 - 20
​$0 for the first 20 days each benefit period
​Days 21 - 100
​$167 per day each benefit period

All costs are your responsibility for each day after day 100 in a benefit period.
Note:
  • If you stop receiving skilled care in the SNF, or leave the SNF altogether, your SNF coverage may be affected depending on how long your break in SNF care lasts.​
  • ​If your break in skilled care lasts more than 30 days, you need a new 3-day hospital stay to qualify for additional SNF care. The new hospital stay doesn’t need to be for the same condition that you were treated for during your previous stay.
  • If your break in skilled care lasts for at least 60 days in a row, this ends your current benefit period and renews your SNF benefits. This means that the maximum coverage available would be up to 100 days of SNF benefits.
Part B (Medical Insurance)
Medicare Part B is medical insurance that helps cover doctors’ services, hospital outpatient care and home health care. Part B helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse.

Cost:

The standard premium for Medicare Part B in 2018 is $134. Retirees with higher incomes may pay a higher premium. Your modified adjusted gross income as reported on your IRS tax return from 2 years prior determines your cost.

Part C (Medicare Advantage)

You may be receiving marketing information and calls regarding Medicare Open Enrollment (through December 31 each year) and/or Medicare Advantage (also called Medicare Part C) plans. Please be aware, you are currently covered under the Rancho Santiago Community College District group retiree plan based upon the collective bargaining agreement and board policies that were in effect on your retirement date. In general, a Medicare Advantage (Part C) plan supersedes any other medical plan, such as your District plan, that coordinates or supplements your Medicare coverage.

That means, your District plan would no longer provide any additional benefits, your only cover-age would be through the Medicare Advantage plan.

If you choose to enroll in a Medicare Advantage plan, you agree to forfeit your benefits coverage through the District. We urge you to think carefully and be fully informed about your benefits before you seek or enroll in coverage other than, or in addition to, the District cover-age.

For additional information about Medicare Advantage plans, please visit www.medicare.gov.

Part D (Prescription Drug Coverage)

Prescription drug coverage is included in your retirement benefits offered through the District and your coverage is considered to be comparable to or better than the prescription drug coverage that is offered through Medicare Part D. Therefore, you do not need to enroll in Medicare Part D. Doing so may cause significant delays in claims processing and may prevent your claim from being paid.


Additionally, enrolling in Medicare Part D means you agree to forfeit your benefits cover-age through the District
Enrolling in the right Medicare coverage is a personal decision based on your unique situation. Before enrolling in or dropping certain Medicare coverage, consult with a Medicare Representative​ to determine what options are right for you.