Doctor visit = $100
Medical Supplies on line item basis adds up to $2000
Diagnostic test = $100
With these amounts, Medicare will pay you 80% of $1500 per MRI, not 80% of $2000 as you were billed. So going back to our scenario where your child has leukemia and went to recieve treatment. Lets do the math of how this would look like under a single payer system that resembles Medicare.
The hospital bills you as follows:
6 MRI's billed at $2000 per MRI = $12000
30 Doctor visits billed at $125 per visit = $3750
Medical supplies used = $2000
12 Diagnostic tests billed at $75 per test = $900
Total Cost = $18650
Medicare reimbursement under part B with "Medicare approved rates":
For MRI's = 80% of $1500 = $1200 per MRI
Doctor visits: 80% or $100 = $80 per visit
Medical Supplies: 80% of $2000 = $1600
Diagnostic tests: 80% of $100 = $80 per test
Medicare would reimburse you $7200 for the MRI's, $2400 for the doc visits, $1600 for the medical supplies, and $900 for the diagnostic tests. The only thing that was covered in full were the diagnostic tests... you got lucky that the "Medicare approved amount" was high enough to cover the $75 per test. Thats a total reimbursement of $12,100. Your total cost was $18650!
