Medicare Part A is the hospital insurance part of your Original Medicare plan. Your Medicare Part A plan covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and certain parts of home health care. You also typically do not pay a premium for Medicare Part A as long as you or your spouse paid Medicare taxes for a certain amount of time, also referred to as “premium-free Part A.”
Besides premium costs, though, other costs are associated with Medicare Part A, such as deductibles. Part A deductibles are different from other Medicare deductibles. They are not charged for the year but for each benefit period instead.
What Is A Benefit Period?
A benefit period is how your Original Medicare plan measures your use of hospital care and skilled nursing facilities services (SNFs). A benefit period begins when you are admitted into a hospital or skilled nursing facility and ends when you have been out of the facility for 60 consecutive days. Once this occurs, a new benefit period begins, and the deductible starts over again. There is no limit to the number of benefit periods that you are entitled to. You may also endure more than one inpatient hospital stay within a single benefit period. If you are discharged, then readmitted days later, you are still covered under one single benefit period.
Part A Benefit Period Costs
The amount you pay during your benefit period is determined by how long your inpatient facility/facilities are. You are required to meet your Part A deductible, as well as pay a daily coinsurance. Coinsurance is the percentage of costs of a covered service you pay once you have met your deductible. Your coinsurance amount is determined by how many days you stay at a hospital or a skilled nursing facility.
Once you meet your Part A deductible during your benefit period, the first 60 days of your inpatient hospital stay are covered 100%. You are not required to pay a daily coinsurance. If you receive services and are admitted to a Medicare-approved skilled nursing facility, you will pay no coinsurance for the first 20 days.
Current Information About Medicare Part A Benefit Periods
Your inpatient hospital stay benefit period begins if you are required to spend two consecutive nights in a hospital. Part A Benefit Periods as of 2021 are broken down as such:
- Initial Deductible: Each initial deductible at the start of a benefit period is $1,484. Medicare will not begin to cover costs until this deductible is met.
- Days 1-60: Your coinsurance amount for the first 60 days of your inpatient stay will be $0.
- Days 61-90: The daily coinsurance amount you will be responsible for is $371.
- Days 91+: Once the first 90 days end, you will begin to use your lifetime reserve days.
Lifetime reserve days are 60 extra days past your original 90 days that you are eligible to use over your lifetime. These days can be applied to multiple benefit periods. Coinsurance costs for each lifetime reserve day are $742. Once these 60 days are used up, you are responsible for 100% of all medical costs.
Skilled Nursing Facility costs:
- Initial Deductible: same as the initial deductible as an inpatient hospital stay.
- Days 1-20: Your coinsurance amount will be $0.
- Days 20-100: Your daily coinsurance amount is $185.50.
- Days 101+: You are responsible for 100% of all costs.
Reach Out To The Medicare Experts Today
At Game Changing Benefits, we want you to have as much information as possible regarding your Medicare plan options. If you need help learning more about Medicare Part A or any other part of Medicare, give us a call today.