AHIP Practice Exam

What is Mr. Patel's financial responsibility for inpatient hospital services under Original Medicare after 60 days?

1. A fixed copayment amount applies

2. A single deductible amount remains

3. A per-day payment starts after 60 days

4. All costs are covered indefinitely

The correct answer is: A per-day payment starts after 60 days

In the context of Original Medicare, after an inpatient hospital stay, there are specific guidelines regarding cost-sharing that beneficiaries must understand. Under Original Medicare, there's an established structure for the coverage of inpatient hospital services that includes a benefit period. Once a patient has been in the hospital for more than 60 days during a benefit period, they are responsible for a per-day payment that begins on the 61st day of their stay. This is referred to as the daily coinsurance rate, which reflects the cost-sharing structure for extended inpatient hospitalization. The daily coinsurance amount is a fixed sum, and it applies for each day starting from the 61st day up to the 90th day of inpatient care in a benefit period. If a patient stays longer than 90 days, the costs increase further because there are lifetime reserve days that can be used, but utilizing these entails additional financial responsibility. This structured system ensures that while Original Medicare covers significant costs for inpatient services, it also establishes a duration limit after which the patient shares in those costs. The other options refer to simpler or incorrect arrangements of cost-sharing that do not align with the specific provisions in Original Medicare for inpatient hospital stays. The emphasis on per-day payment after 60 days reflects the actual framework