What is Medicare Part A and what does it cover? This is an important question to ask, but many people new to Medicare get confused at the different parts of Medicare. For starters, Original Medicare is made up of two parts: Medicare Part A (which mainly covers hospitalization) and Medicare Part B ( which covers your day-to-day medical coverage). This article will explain Part A but you can read more about Medicare B here
What is Medicare Part A and What Does it Cover?
Medicare Part A is hospitalization coverage. Basically it covers anytime you’re in the hospital, Skilled Nursing Facilities, Hospice or Home Health Services. One thing many people don’t realize is that Medicare Part A, while for most people is premium-free ($0 monthly cost), it still has out of pocket costs and limitations on coverage.
What Will You Pay with Part A?
- Part A Premium for most people: $0
- Part A Premium if you do not meet the premium-free qualifications: $422
- Hospital/Mental Inpatient Benefit Period Deductible* From Day 1-60: $1,364
- Hospital/Mental Inpatient Coinsurance Days 61-90: $335 per day
- Hospital/Mental Inpatient Coinsurance Days 91-150 (Lifetime Reserve Days): $670 per day
- Hospital/Mental Inpatient Costs after Lifetime Reserved Days: 100%
- Skilled Nursing Facility (SNF) Coinsurance Days 1-20: $0
- SNF Coinsurance Days 21-100: $167.50
- SNF Coinsurance Beyond Day 100: 100%
- Hospice Costs**: $0
- Health Home Services**: $0
*Deductible can be charged multiple times per year, since it is a “benefit period” deductible. For instance, if you enter the hospital on January 5th for one week, you’d be charged the deductible. Then if 60 days pass since your exit from the hospital and you enter the hospital again, say May 15th, you would be charged the Part A deductible again.
**You can still be charged 20% for durable medical equipment through Part B, and in addition, if you are in Hospice care, if you seek respite care you can be charged up to 5%.
What Does Part A Not Cover?
Here are a few things Medicare Part A does not cover: day to day care (that is covered by Part B), hearing aids, dental, vision, acupuncture, non-donated blood, and prescription drugs.
Important Things to Note About What Part A Does Not Cover:
As you can see with Medicare Part A you are partially covered for services, but can still have significant and varying out of pocket costs, and it does not put a cap on your out of pocket spending. One way to limit these costs is to enroll in additional Medicare insurance.