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 1994.
12.01 :  1995 Medicare Deductible and Premium

Contact:  Anne Verano  (202) 690-6145
December 1, 1994

         MEDICARE ANNOUNCES DEDUCTIBLE AND PREMIUM FOR 1995

     The Health Care Financing Administration today published
notices in the Federal Register announcing Medicare's 1995
hospital deductible and the monthly Part B premium.

     The Medicare Part A deductible for beneficiaries admitted to
hospitals in 1995 will be $716.  The Medicare Part B premium for
calendar year 1995 will be $46.10 a month, an amount set
previously by law. 

     DEDUCTIBLE:  

     The Part A deductible, a $20 increase over 1994, is based on
the rates that Medicare pays hospitals for inpatient care.  The
prospective payment system is updated each year to reflect
increases in hospital costs and legislated changes.

     During each benefit period, the deductible is the
beneficiary's sole cost for up to 60 days of necessary hospital
services.  For hospital and skilled nursing facility care lasting
longer than 60 days in 1995, beneficiaries will be responsible
for a coinsurance payment of $179 per day from the 61st through
90th day.
 
     Benefit periods expire after 60 days without inpatient care
from a hospital or skilled nursing facility, at which time the
beneficiary is again responsible for the $716 deductible for any
new hospitalization.

     A coinsurance rate of $358 per day has been set for 60
Medicare "reserve days" a beneficiary is entitled to once in a
lifetime for extended stays of longer than 90 days.

     When a beneficiary needs therapeutic care in a skilled
nursing facility after at least three consecutive days of
inpatient hospital care, Medicare pays 100 percent of covered
expenses for the first 20 days.  A coinsurance payment of $89.50
a day will be required for the 21st through the 100th day.
 
     PART B PREMIUM:

     The Medicare Part B premium for calendar year 1995, at
$46.10 a month, is an increase of $5 from the 1994 level.

     The new premium was set by Congress as part of the Omnibus
Budget Reconciliation Act of 1990.

     Part B helps beneficiaries pay for the services of
physicians and other medical practitioners, hospital outpatient
services, independent clinical laboratory work, and durable
medical equipment and supplies.
 
     Approximately 95 percent of the 36 million Medicare
beneficiaries are enrolled in Part B. Expenditures for Part B in
calendar year 1995 are projected to be $67.5 billion, an increase
of 11.6 percent from the estimated 1994 level.
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