Limitations

Claim limits and changes to the IHC Policy will be determined annually by the County IHC Board. Most services will  be reimbursed at the 50% ratio, except for in-patient hospital services

There is a $15,000.00 fiscal year limit for hospital services and a $5,000.00 fiscal limit for ambulance service. (This is per patient and amounts cannot be transferred from one patient to another.) Primary Care Services to an eligible individual will be subject to a limit of $4,000.00 per patient per fiscal year and claims are paid at 65%. (Primary Care co-pays are not eligible because they are considered reasonable and generally result after the Medicare reimbursement.)