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What Does Medicare Part A Cover and Cost?

A common question is “What does Medicare Part A cover?” and what are the costs involved. Medicare Part A typically covers inpatient hospital care, skilled nursing facilities, hospice, lab tests, surgery and home health care.

So, How Much Does Medicare Part A Cost?

Good news, not everyone has to pay a premium for Medicare Part A. Most people have already paid for it while they (or their spouse) were working while paying into social security.

Essentially, if you or your spouse worked for longer than 10 years, you have a $0 premium cost.

However, if you or your spouse worked less than 10 years, you will have to pay a monthly premium.

If your time worked was between 7.5 and 10 years, you will pay a monthly premium of $240.

If you worked for fewer than 7.5 years, you will pay a monthly premium of $437.

There are exceptions, but that is the general rule.

How Much Are Deductibles Under Medicare Part A?

Part A deductibles apply to each hospital benefit period – essentially when you enter a hospital or skilled nursing facility – ending when you’ve been out for 60 consecutive days.

How Much Are Copayments Under Medicare Part A?

Copayments will apply once you stay in a hospital for longer than 60 days and 20 days in a skilled nursing care facility for one benefit period.

How Much Are Hospital Stays Under Medicare Part A?

The cost depends on how long you stay. If you stay is 60 or fewer days, you pay $1,364 deductible, then nothing. If your stay is 61-90 days, you will pay an additional $341 per day. If your stay goes to 91-150 days, it will cost $682 per day. If your stay exceeds 150 days, you will pay the full cost of your hospital stay.

How Much Are Skilled Nursing Facility Stays Under Medicare Part A?

There are no deductibles for skilled nursing facility stays. Medicare will only cover 100 days, provided you meet the following criteria.

  • 3-Day Hospital Stay: You must have been at a hospital for 3 days AND been admitted to the hospital as inpatient AND visited the skilled nursing facility within 30 days of the hospital stay.
  • Care Level: You must need skilled therapy services 5 days a day or skilled nursing care 7 days a week.
  • Part A: You are required to have had Part A while you were in the hospital.

Stays for only personal care are not covered. If your stay runs longer than 20 days, you’ll pay a premium of $170.50 per day for days 21-100, then all costs after day 100.

How Much Will I Pay For Home Medical Care Under Medicare Part A?

There are no copayments or deductibles for home health care, but you must have a doctor certify that you need medical care at home, you are homebound and that you need skilled care.

These services must be ordered from a doctor, from a home health agency Medicare approves, after documenting a face-to-face visit with you up to 3 months before or 1 month after the start of the service, including a signed plan for your care.

How Much Will I Pay For Hospice Care Under Medicare Part A?

There is no copayment or deductible for hospice care. You will be responsible for paying a small part of the medication and inpatient respite care.

Wondering what Part B covers? Find out here.

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