Under Medicare Part B, who is responsible for the 20% coinsurance for enteral formula?

• A. The patient
• B. Medicare
• C. The supplemental insurer
• D. The hospital

Answer: (A)

Under Medicare Part B, covered medical supplies and services have cost sharing: Medicare pays 80% of the approved amount, and the patient is responsible for the remaining 20% coinsurance (after meeting the Part B deductible, if applicable). Enteral formula prescribed for home use qualifies as a Part B-covered medical supply, so the patient bears the 20% coinsurance. A supplemental insurer (like a Medigap plan) could help cover that coinsurance if the patient has such coverage, but the base obligation rests with the patient. The hospital isn’t responsible for paying the 20% coinsurance in this scenario.