POMS Reference

HI 00601: Hospital Insurance

TN 2 (10-04)

A. Coinsurance

The beneficiary is responsible for a daily coinsurance amount of one-fourth of the inpatient hospital deductible for the 61st through the 90th days of inpatient hospital services used during each benefit period.

Where the actual charge to the patient for the 61st through the 90th day of inpatient hospital services is less than the applicable coinsurance amount, the coinsurance is the actual charge. (Where the actual charge to the patient for lifetime reserve days is less than the coinsurance amount for those days, the beneficiary is deemed to have elected not to use the days because he/she would not benefit from their utilization.) (See HI 00601.065B.)

The following chart shows the inpatient hospital coinsurance amounts for benefit periods beginning in each year since 1974:

Year in Which Benefit Period Began

Coinsurance Amount

2018

$355.00

2017

$329.00

2016

$322

2015

$315

2014

$304

2013

$296

2012

$289

2011

$283

2010

$275

2009

$267

2008

$256

2007

$248

2006

$238

2005

$228

2004

$219

2003

$210

2002

$203

2001

$198

2000

$194

1999

$192

1998

$191

1997

$190

1996

$184

1995

$179

1994

$174

1993

$169

1992

$163

1991

$157

1990

$148

1989

$0 *

1988

$135

1987

$130

1986

$123

1985

$100

1984

$89

1983

$76

1982

$65

1981

$51

1980

$45

1979

$40

1978

$36

1977

$31

1976

$26

1975

$23

1974

$21

*Coinsurance was not charged for inpatient hospital care in calendar year 1989 due to Catastrophic Coverage; the deductible was applied.

B. Lifetime reserve coinsurance

The beneficiary is responsible for a daily coinsurance amount of one-half of the inpatient hospital deductible for each of the lifetime reserve days (the 91st through the l50th day) used in a benefit period.

The following chart shows the lifetime reserve day coinsurance amounts for benefit periods beginning in each year since 1974:

Year in Which Benefit Period Began

Coinsurance Amount

2018

$670

2017

$658

2016

$644

2015

$630

2014

$608

2013

$592

2012

$578

2011

$566

2010

$550

2009

$534

2008

$512

2007

$496

2006

$476

2005

$456

2004

$438

2003

$420

2002

$406

2001

$398

2000

$388

1999

$384

1998

$382

1997

$380

1996

$368

1995

$358

1994

$348

1993

$338

1992

$326

1991

$314

1990

$296

1989

$0 *

1988

$270

1987

$260

1986

$246

1985

$200

1984

$178

1983

$152

1982

$130

1981

$102

1980

$ 90

1979

$ 80

1978

$ 72

1977

$ 62

1976

$ 52

1975

$ 46

1974

$ 42

* Coinsurance was not charged for inpatient hospital care in calendar year 1989 due to Catastrophic Coverage; the deductible was applied.