How will my Medicare A insurance work if I’m going to stay in the hospital for surgery? Am I required to pay my co-pay for the bill right away or do I need to wait for Medicare to pay the bill first?

Your Medicare A insurance will cover 80% of the cost of your stay in the hospital while you’ll shoulder 20% of the cost. Medicare Part A will cover your stay in a semi-private room including nursing, drugs, medical supplies, and hospital services. If you have Medicare Advantage plan, you’re usually required to first pay the co-pay for the hospital stay. The hospital will then file a claim with Medicare so that Medicare can pay the remaining cost.

If you don’t have other insurance plans apart from Medicare A, then you probably won’t be required to pay anything yet. After the hospital has filed a claim to Medicare, Medicare will send you an Explanation of Benefits (EOB) that will show what you owe the hospital. You should compare the EOB with the bill the hospital will send you because they should indicate the same amount. You can then pay the hospital for your part of the bill.

Medicare A also works with your supplemental insurance. If you have a Medicare supplemental plan or a Medigap policy, then you also don’t have to render your co-pay to the hospital right away. You will need to file a claim with the insurance company if the hospital doesn’t do so for you. The provider of the supplemental insurance plan will then contact you regarding your co-pay, if there is any.

Answer by general public - June 19, 2009 @ 3:36 pm

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