Question:
What is the 20% cost estimated after medicare pays for surgery?

I am 30 and disabled. I have Medicare only. I was wanting to know from someone who has had the surgery and only had medicare of what the left over cost were.    — Rita W. (posted on June 21, 2002)

June 21, 2002
My understanding of how Medicare works is this: They pay 80% of the Medicare amount for services, leaving you responsible for 20%. Let's say that the actual cost of your surgery was $40,000 and of that amount Medicare "approved" $30,000, they would pay 80% of the $30,000 and if the provider is contracted with Medicare, they would write off the balance. Medicare bases their approved amounts on Reasonable & Customary charges for a specific area. It may be worth checking with your Medicare provider to see if they have any information for you. Good luck!
   — Rosario T.

June 21, 2002
Ooops, I meant to say that you would be responsible for 20% of the approved amount, not 20% of the actual charge. Sorry about that!
   — Rosario T.

June 21, 2002
If you have Medicare and you are inpatient for this surgery your bills will be broken down into the dr fees (part B) and the hospital fees (part A). The Dr services involved will be paid by Medicare at 80% of the allowed amount and you will be resp for 20% of the allowed amount. You will owe the hospital $812 for the inpatient deductible. Medicare does not pre approve ANY services. It is totally based on Medical neccesity.
   — Dawn E.