HI 00601.560: Inpatient Hospital Coinsurance

changes
←	*	→

~~Effective Dates: 11/21/2016 - Present~~
Effective Dates: 01/02/2018 - Present
TN 2 (10-04)
HI 00601.560 Inpatient Hospital Coinsurance
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.

POMS Reference

HI 00601.560: Inpatient Hospital Coinsurance