Medicare Part A Information
1. Inpatient Hospital Care
- Up to 90 days of inpatient hospital services in each benefit period
- An additional 60 lifetime reserve days
- A benefit period begins when you are admitted to the hospital and ends when you have been out of the hospital for 60 days, or have not received Medicare-covered care in a skilled nursing facility (SNF) or hospital for 60 consecutive days from your day of discharge.
Medicare provides 60 lifetime reserve days of inpatient hospital coverage following a 90-day stay in the hospital. These lifetime reserve days can only be used once - if you use them, Medicare will not renew them. Very few people remain in a hospital for 150 consecutive days. In the rare event this does occur, most Medigap policies contain a benefit for an additional 365 hospital days during your lifetime. Medigap policies are designed to pay the copayments below; certain policies also pay the deductible. Learn more.
As of 2015, Medicare requires the following out-of-pocket inpatient hospital costs:
- Deductible of $1,288 for the first day you are a hospital inpatient. This single deductible covers the next 59 days in the hospital for the same benefit period.
- Copayment of $322 per day for days 61-90 (after you have been in the hospital for 60 days) Copayment as much as $9,660.
- Copayment of $644 per day for days 91-150 (after you have been in the hospital for 90 days; these are your 60 lifetime reserve days) Copayment as much as $38,640.
- 151 Days or more You Pay All The Costs
2. Skilled Nursing Facility (SNF) Care
Medicare covers up to 100 days of care in a skilled nursing facility (SNF) for each benefit period if all of Medicare's requirements are met, including your need of daily skilled nursing care with 3 days of prior hospitalization.
Medicare pays 100% of the first 20 days of a covered SNF stay. A copayment of $161.00 per day (in 2015 ) is required for days 21-100 if Medicare approves your stay. Copayment as much as $12,880.
3. Home Health Services
Medicare covers up to 100 home health visits per period of illness following a hospital stay. Additional home health benefits are available under Part B. Home health visits under both Parts A and B must meet the following conditions:
- A physician has certified you as homebound
- Intermittent skilled nursing or therapy services are required
- Services are provided by a Medicare-certified home health agency
4. Hospice Care
Hospice care is available for terminally ill patients. The goal of hospice care is to keep the patient as comfortable as possible. It does not provide treatment for the terminal illness. Learn more about hospice care (Medicare publication).
5. 2015 Part A Premiums, Deductibles & Coinsurance
The Medicare Part A chart lists the Part A deductibles and coinsurance for inpatient hospital and skilled nursing facility (SNF) care for Original fee-for-service Medicare. For a comprehensive list of Part A and B costs, contact us for details on Medicare Benefits & Cost-Sharing for 2016.
Medicare Part A Coverage & Deductibles
Medicare Part B (click here)
- Due to many Insurance Companies selling Medigap and Advantage policies we are unable to advise until we are aware of your needs.