The amount you pay may change each year if the amount people are paid to work in hospitals in your area changes. If the amount people are paid to work in hospitals in your area doesn’t change, the amount you pay for each service you get will be the same each year until it equals 20% of the payment rate. Once it equals 20% of the payment rate, the amount you pay may change each year if the payment rate or hospital wages in your area change.
The amount you pay can’t be more than a certain percentage of the payment rate, and that percentage goes down over time. In 2002 and 2003, the maximum percentage you have to pay is 55%. In 2004, it goes down to 50%.
For example, Mr. Walters gets a hearing test every year at his local outpatient hospital department. The amount he pays for this service is the same each year until 2003. In 2003, the amount he pays equals 20% of the payment rate. Therefore, after 2003, the amount he pays increases as the payment rate increases. However, his costs are still 20% of the payment rate.
