Medicare Part A

what does medicare part a cost

Medicare Part A Information

Medicare Part A is automatically given to you the first day you turn 65, are a citizen of the United States, and have paid taxes from working*. For individuals under 65 and with certain disabilities, Part A starts after receiving disability benefits from Social Security for 24 months.  If you have ALS, you get Part A and Part B the month your disability benefits begin.

*If you or your spouse paid sufficient Medicare taxes while working (most people), Part A is premium-free .  If you have to buy Part A, you may have to pay up to $407 each month.

What does Medicare Part A Cover?

Medicare Part A covers inpatient hospital care, inpatient skilled nursing facility care, hospice, home health care services, and inpatient care in a religious non-medical health care institution.  If you are unsure whether you have Part A coverage, look at your Medicare card for the Part A effective date.

Part A Covered Services

If there is blood available at a blood bank, the hospital gets the blood at no charge.  You won’t have to pay for the blood or replace it.  If there is a shortage of blood, you must pay the first 3 units of blood you receive in a calendar year.  Blood can be donated by you or someone else to help prevent paying for the first 3 units of blood.

Medicare Part A covers medically necessary home health care services.  You must see a doctor face-to-face so they can certify that you need home health care services.

You pay nothing for the cost of home health care services and 20% for durable medical equipment that is Medicare-approved.

Part A Coverage for hospice care includes: Drugs, items and services

needed for pain relief and symptom management, medical, nursing, social services, certain durable medical equipment, and services that Medicare doesn’t usual cover (spiritual and grief counseling).  A doctor must certify that you’re terminally ill and expected to live 6 months or less to receive Part A hospice care.  There is a copay for outpatient prescription drugs for pain and symptom management.

Medicare Part A coverage includes hospitals, critical access hospitals, inpatient rehabilitation facilities, long-term care hospitals (not long-term care), inpatient care as part of a qualifying research study, and mental health care.

There is a Part A deductible for hospital days 1-60.  The Medicare hospital annual deductible in 2015 is $1,260.  There is no coinsurance for these days.

Days 61-90 have coinsurance you have to pay each benefit period. $315 a day per benefit period.

Days 91+ you there is coinsurance per lifetime reserve days (60 over lifetime).  $630 a day for days 91-150.  After lifetime reserve days are used, you pay 100% of the cost.

*Inpatient psychiatric care in a freestanding psychiatric hospital limits you to 190 days in a lifetime.

  • Skilled Nursing Facility Care

You must have a 3-day minimum medically necessary inpatient hospital stay for a related injury or illness for Part A to pay it’s share.  If you don’t have a 3-day minimum inpatient hospital stay, Medicare will not pay.  The 3-day stay does not include the day you are discharged.  Doctors must certify that you need skilled care.

Days 1-20 are provided at no cost to you. $0

Days 21-100: $157.50 per day

After day 100, Medicare doesn’t pay for skilled nursing facility care.

Learn more about Medicare Part A by downloading the “Medicare & You ” handbook.


Category: Insurance

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