Ethel has Part B coverage and incurs $1,000 in Medicare-approved health care charges. What must she pay?

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Part B of Medicare covers a range of outpatient services and helps pay for medically necessary services, but it does not cover everything at 100%. When a beneficiary like Ethel incurs medical expenses, there are both deductibles and coinsurance percentages that apply.

In this case, Ethel's $1,000 in Medicare-approved health care charges would first be subjected to an annual deductible, which she must pay out of pocket before Medicare coverage kicks in. For 2023, the standard Part B deductible is $226. Once she has met that deductible, Medicare typically pays 80% of the remaining charges. This means Ethel would be responsible for the remaining 20% coinsurance on the amount billed after her deductible has been met.

So, with her incurred costs of $1,000, Ethel will first pay the deductible amount, and then she will be responsible for 20% of the remaining balance after the deductible is applied, making this option the correct response.

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