Medicare & Insurance

Medicare Deductible and Coinsurance Amounts for 2025

Part A Inpatient Deductible

The inpatient deductible pays for inpatient hospital, skilled nursing facility, and some home health care.

For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2025 = $1,676) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days. You have 60 Lifetime Reserve Days available at day 91.

For each benefit period you pay:

• Daily Coinsurance for 61st - 90th Day = $419.00 per day
• Daily coinsurance for lifetime reserve days = $838.00 per day

Part B Outpatient Deductible

The outpatient deductible covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment

Medicare pays all covered costs except the Medicare Part B deductible ($257.00 per year). You pay 20 percent of the Medicare-approved amount for services after you meet the $257.00 deductible.

Skilled Nursing Facility Co-insurance

• Days 1 - 20 Medicare Covers
• Days 21 - 100 $209.50 per day

In addition to your deductible, you may be liable for co-insurance.

Centra bills all Blue Cross Blue Shield (BCBS) plans for inpatient and outpatient services provided all billing information is given at time of registration or admission.

• Verify your BCBS information is correct including policy number and contact a customer service representative with any corrections or changes.
• Submit changes online using the Update Insurance function on this site in the My Account section. Note that you must be logged in to access this function.

Patients are encouraged to respond promptly to all requests from BCBS. Failure to comply with BCBS requirements may result in a partial or complete insurance denial. Balances denied by BCBS as patient responsibility will be billed to the patient.

Certain BCBS plans require annual deductibles, an annual expense paid by the patient before insurance benefits can begin, be met before benefits are applied. Coinsurance is the portion of the total bill that is the patient/guarantor's responsibility. After BCBS processes your claim and payment is received, we will mail you a statement. Please pay your balance owed promptly.

Centra bills all insurance carriers for inpatient and outpatient services.

If the insurance carrier is a PPO or HMO, in-network benefits will apply for plans contracted with Centra. Please see Contracted Managed Care Plans listed below.

Complete billing information required by the insurance carrier or employer must be provided at the time of registration or admission. Please verify your insurance carrier information via phone, email or online.

Patients are encouraged to respond promptly to all requests from the insurance carrier. Failure to comply with insurance carrier requirements may result in a partial or complete insurance denial. Balances denied by the insurance carrier as patient responsibility will be billed to the patient.

Certain insurance plans require annual deductibles be met before benefits are applied. The deductible is an annual expense that you must pay before your insurance benefits can begin. Coinsurance is the portion of the total bill that is the patient/guarantor's responsibility. After your insurance processes your claim and payment is received, we will mail you a statement. Please pay your balance owed promptly.

If your insurance carrier has not made payment within a reasonable period of time, usually 60 days after billing, and has not responded to our attempts to resolve payment matters on your behalf, the balance owed may become your responsibility.

Contracted Managed Care Plans

Centra will bill your primary and secondary insurance carrier for inpatient and outpatient services. Many insurance plans require approval before services can be performed. Before your visit, review your health plan booklet or call your insurance company to clarify your specific policy plan benefits and requirements.

Below is a list of Centra contracted insurance carriers: