Medicare Part A: Costs and Coverage

Learn what Fees you will pay with Medicare Part A

by Ray Wilson+ on Feb 11, 2018 | 2 Comments

Medicare is split into two parts: Part A covers hospitalization services and Part B covers day-to-day medical care. This articles focuses on Medicare Part A but when you are done, check out our Medicare Part B Costs, Fees and Coverage page.

This article was updated on Feb 10, 2018

 

 

Medicare Part A Covers

In general,Medicare Part A covers:

  • Hospital care
  • Skilled nursing facility care
  • Nursing home care (as long as custodial care isn’t the only care you need)
  • Hospice
  • Home health services

Your Costs with Medicare Part A

Most people receive Medicare Part A premium-free but without a Medigap or Medicare Advantage plan, you must pay the following fees for services:

  • Hospital deductible for each benefit period: $1,340
  • Hospital Days 61-90 is $335 per day  per day
  • Hospital Lifetime Reserve Days 91-150 is $670 per day per day*
  • Skilled Nursing Days 21-100 is $167.50 per day
  • Hospice care: no more than $5 for Rx
  • Hospice care: May pay 5% for respite care
  • No limit on your out of pocket costs

*Medicare offers 60 lifetime reserve days after that period all hospital costs are your responsibility.

How to Reduce Medicare Fees

There are two main options to pay for the Medicare Part A fees above, if you are not insured through your employer or receive VA benefits: 1) Medigap and 2) Medicare Advantage. Remember you must be enrolled in BOTH Medicare Part A and Part B to enroll in either of these insurance options.

Medigap
Medigap fills in the gaps by covering deductibles and coinsurance that Medicare leaves. For instance Medigap Plan F covers all your coinsurance, copays, coinsurance, excess charges, adds an additional 365 hospital days, and offers foreign emergency healthcare. With Plan F, once you pay your monthly premium you would have no out-of-pocket costs if Medicare covers it. All Medigap lettered plans are standardized, therefore you only need to choose a plan based off price and company stability.

Medicare Advantage
Medicare Advantage replaces Original Medicare. MA plans trade a large nationwide network for a small HMO-like network with added benefits such as Rx, dental, and vision. At a minimum Medicare Advantage must cover all that Original Medicare covers, but your MA plan may cover services differently. There is a max out of pocket cost of $6700 with MA. Since Medicare Advantage plans are not standardized you’ll want to research all the plans in your area.

For further questions about how to cover your Part A costs call the number above or get an instant Medicare Insurance quote to see benefits side by side.  To learn about Medicare Part B, visit our Part B page here.

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Reader Comments and Questions

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By DEBBIE on August 02, 2018

Hi question for my husband. He is still working at 65 and has private insurance through his employer He turned 65 in July. Should he apply for Medicare A still? He plans on retiring in July 2019. Thank you.

Debbie,
Typically you want to elect Medicare Part A upon turning 65 even if you have coverage though work. Please confirm this with his employers insurance provider.
Since he has coverage via work, he can postpone Medicare Part B until he retires. By postponing his B he also pushes back his Medigap initial election period which is good. When he does retire, we can help him enroll in Medigap and Part D drug coverage.
-Michelle from Senior65.com


By Reynaldo on May 19, 2016

Are doctor's and surgeons covered under your Part A ? I wasn't planning on signing up for Part B because I go to the VA for my doctor's visits and it looks like A would cover me for hospitalization. Thoughts?

Reynaldo,
Doctors and surgeons are not covered by Part A. You would need Part B to partially cover their costs, even when you're in the hospital. We, as does the VA, highly recommend that you keep your private insurance/Medicare, even when most of your care is at the VA. We also suggest enrolling in a Medicare Advantage or Medigap plan to offset that costs of Original Medicare. To learn more about Medicare Health Plans call one of our Senior65 licensed independent agents at 800-930-7956.
-Eric from https://www.senior65.com/



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