AHIP Practice Exam

What could you advise Mr. Patel to expect regarding costs if he is hospitalized under Original Medicare?

1. Only annual deductibles apply

2. Out-of-pocket costs may increase significantly

3. Copayments vary from provider to provider

4. Coverage includes all hospital costs indefinitely

The correct answer is: Out-of-pocket costs may increase significantly

When Mr. Patel is hospitalized under Original Medicare, he should expect that out-of-pocket costs may increase significantly. Original Medicare consists of two main parts: Part A (hospital insurance) and Part B (medical insurance). While Part A covers inpatient stays, services, and some supplies, beneficiaries are still responsible for certain costs. Upon being admitted to the hospital, Mr. Patel will be subject to a variety of out-of-pocket expenses, including an initial deductible for Part A, which must be met before coverage kicks in for inpatient services. Following the deductible, there are daily coinsurance amounts that apply after a certain number of days in the hospital, which can add to the total cost of care. These costs can accumulate rapidly, especially for extended hospital stays, leading to significant out-of-pocket expenditures. In contrast, the other options do not accurately reflect the situation. Annual deductibles are just one part of the overall cost structure; they do not encompass the comprehensive cost implications of hospitalization. While copayments can vary for different services, under Original Medicare, hospitalized patients primarily deal with the deductible and coinsurance rather than provider-specific copayments. Lastly, Original Medicare does not cover all hospital costs indefinitely; there are limits on the lengths of stay it covers