What will you pay for Part A?
Medicare Part A pays most of the cost for hospital stays lasting up to 60 days. But if you have a very long stay, you can expect to pay a large share of the cost. You will pay a deductible for each benefit period In Medicare Part A, a benefit period begins the day you go into a hospital or skilled nursing facility. It ends when you have been out for 60 days in a row. You may be in the hospital more than once during one benefit period. There is no limit on the number of benefit periods that Medicare will cover. Part A charges a deductible for each benefit period. and a daily copayment after day 60 in the hospital.
Part A is premium free if you or your spouse worked and paid Medicare taxes for at least 10 years. There are no limits on your out-of-pocket spending with Part A. Your expenses could be substantial if you have a chronic condition or serious illness.
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2013 Part A Costs
- $0 for most people
- Up to $441 per month, if applicable
- $1,184 per benefit period
- $0 per day for inpatient hospital days 1-60 of each benefit period
- $296 per day for inpatient hospital days 61-90 of each benefit period
- $592 per day for lifetime reserve day In Medicare Part A, a set number of covered hospital days you can draw on if you are in the hospital longer than 90 days in a benefit period. You have 60 lifetime reserve days. A lifetime reserve day cannot be replaced. When it is used up, it is gone.
91 and beyond of each benefit period (up to a maximum of 60 days over your lifetime)
- $0 per day for skilled nursing facility days 1-20 of each benefit period
- Up to $148 per day for skilled nursing facility days 21-100 of each benefit period
- All costs for skilled nursing facility days 101 and beyond of each benefit period
- Up to $5 per prescription for medications for pain and symptom management during hospice care
- 20% of the cost for durable medical equipment used at home, such as a walker or wheelchair
- 5% of the Medicare-approved amount The amount Medicare determines to be reasonable for a covered service. Providers who “accept assignment” agree to accept this amount as payment in full. Providers who accept Medicare but not assignment can charge up to 15% above this amount.for short-term hospice care given by another caregiver, so the usual caregiver can rest
How does this work?
A benefit period begins when you enter the hospital and ends when you have been out of the hospital for 60 days in a row. If you’re in and out of the hospital several times within a few weeks for the same condition, that’s still one benefit period.
If your hospital stay lasts longer than 60 days in a benefit period, then you’ll pay a substantial copayment for each day between days 60 and 150.
Medicare Part A limits the number of long hospital stays (stays of more than 90 days) it will pay for. When you join Part A, you’ll get a “lifetime reserve” of 60 days. Each time you stay in a hospital more than 90 days, you can use lifetime reserve days to cover the number of days you stay beyond 90.
Once you’ve used up your lifetime reserve, Part A will pay only for the first 90 days of any hospital stay. And that’s subject to the normal deductibles and copays. After 90 days, you’re responsible for paying for your own care. Medicare Part A also limits the number of days in a psychiatric hospital it will pay for during your lifetime.
Here are some examples.
*These examples show hospital charges only. There may be additional cost sharing for services such as doctors, lab tests and X-rays.