Medicare Part A
Get Local Medigap QuotesCommonly referred to as the "Hospital Part"
Most people refer to Medicare Part A as the "Hospital" part but there is more to the story. Skilled Nursing Facility stays and Hospice care are also included in your Medicare Part A.
How Much is Part A?
If you have a work history that is at least 10 years (or 40 quarters) congratulations! Your Medicare Part A benefits are free. If your work history is not that long, unfortunately, you will have to buy into Part A.
If you have to buy into Part A there is a required monthly premium, that cost can vary depending on your work history. People who’ve less than 30 quarters of work history will pay $506 per month for Part A. For those beneficiaries with at least 30 quarters, the monthly premium is $278.
Who’s Eligible for Part A?
If you are about to turn 65 and you are currently receiving Social Security benefits, you will be automatically enrolled and you should receive all of your important documents in the mail around 3 months before your 65th birthday.
If you do not receive your documents, contact your local CMS (Centers for Medicare & Medicaid Services) office.
People under the age of 65 who have a serious medical illness, such as End-Stage Renal Disease, are likely eligible for Medicare Part A. You should contact your local CMS Office for more information.
If you’re not currently receiving Social Security benefits, you will have to enroll in Part A on your own. If you are still currently employed and turning 65, you should enroll in Part A as early as possible to protect yourself from late enrollment penalties later. So it’s a good idea to enroll even if you don’t think you need it yet.
What Does Medicare Part A Cover?
DAYS 1 - 60
DAYS 61 - 90
DAYS 91 - 150
If you have an extended day that is over 90 days you are now responsible for a $800 per day co-payment. If you stay the full 60 remaining days your co-payments total $48,000.
Medicare also has included a limit on the use of these days, they are labeled your "Lifetime Reserve Days" and once they are used they can never be used again.
DAYS 150+
Additional benefits, Medicare Part A covers:
Skilled Nursing Facility
Days 1 - 20
Days 21 - 100
Hospice
Who is hospice for?
Hospice care is for people with a life expectancy of 6 months or less (if the illness runs its normal course)
If you live longer than 6 months, you can still get hospice care, as long as the hospice medical director or other hospice doctor re-certifies that you’re terminally ill.
What does hospice cover?
Your hospice benefit covers care for your terminal illness and related conditions. Once you start getting hospice care, your hospice benefit should cover everything you need related to your terminal illness.
Can I stop hospice?
If your health improves or your illness goes into remission, you may no longer need hospice care.
You always have the right to stop hospice care at any time. If you choose to stop hospice care, you’ll be asked to sign a form that includes the date your care will end.
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What Does Medicare Part A Not Cover?
To start, Part A does not cover outpatient medical care; including regular check-ups, doctor visits, or simple, outpatient surgeries. Some other medical benefits Part A does not cover even if you do receive legitimate inpatient care, such as:
- Private duty nursing
- More than 100 days of long-term nursing home care
- Personal care items
- Hospital expenses incurred after your lifetime reserve days have run out
What is the Part A deductible for 2023?
The Medicare Part A deductible is $1,600. IMPORTANT: you only have to pay that deductible at the beginning of your benefit period if you get admitted into a hospital as an inpatient. You don’t have to pay that deductible if you are not admitted as an inpatient.
What is the benefit period for Part A?
A benefit period for Medicare Part A starts on the first day you are admitted into the hospital as an inpatient. The benefit period ends after 60 consecutive days from the day you are checked out of the hospital. IMPORTANT: Medicare Part A deductible is paid at the start of each new benefit period, and not annually. You may be required to pay your Part A deductible more than once in the same year if you are unlucky and have multiple inpatient stays separated by 60 days.
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Last updated: 01.05.2023 at 12:01 AM MULTIPLAN_SHDLEAWE001_M.