TN 2 (10-04)

Citations:

Social Security Act, Section 1813

20 CFR 405.113 through 405.115

The beneficiary is responsible for an inpatient hospital deductible amount before the program begins paying for inpatient hospital services in each benefit period. The Secretary has in the past been required to determine each year the amount of the deductible for the following year. For 1987, however, the amount of the deductible has been set by law at $520. For each year after 1987, the Secretary is required to promulgate the deductible and related coinsurance amounts between September 1 and September 15 of the preceding year.

For inpatient hospital services rendered in years prior to 1982 and after 1986, the applicable inpatient deductible is the one in effect during the calendar year in which the beneficiary's benefit period begins (i.e., in most cases, the year in which the first inpatient hospital services are furnished in the benefit period). For services rendered in 1982 through 1986, the applicable deductible is the one in effect during the year in which the services were furnished. The following chart shows the applicable deductible amounts for benefit periods beginning in each year since 1974:

Expenses incurred in one benefit period cannot be applied toward the deductible in a later benefit period. Expenses incurred in meeting the blood deductible do not count toward the inpatient hospital deductible.