Costs and Coverage of Medicare Part A

Medicare Part A is the component of your Medicare insurance that deals with Hospital Insurance.  For most people, there is no monthly premium for Medicare Part A, as long as you or your spouse have paid enough Medicare taxes while working.   However, while you usually don’t need to pay monthly premiums for Part A, many services will involve some out-of-pocket costs. 

Receiving blood in the Original Medicare Plan, for example, will require you to pay for the first 3 pints you get as an inpatient.  After that, you will be responsible for 20% of the Medicare-approved amount.  An exception to this cost is if you or someone else donates enough blood to replace the blood you received. 

For home health care, you pay nothing for the home health care services and 20% of the Medicare-approved amount for necessary durable medical equipment.  For hospice care, you will need to cover a copayment of up to $5.00 per prescription for outpatient prescription drugs, as well as 5% of the Medicare-approved amount for inpatient respite care.  Also, if you receive hospice care somewhere other than for short-term general inpatient/respite care, you might be responsible for the cost of room and board.

In the case of hospital stays, you will need to pay a $1024 deductible and $0 coinsurance for 1 – 60 days each benefit period.  For days 61 – 90 each benefit period, you will cover $256.  Following day 90 for each benefit period (for up to 60 days over your lifetime), you will pay $512 per lifetime reserve day.

For skilled nursing facility stays, you will pay nothing for the first 20 days each benefit period, and $128 per day for days 21 – 100.  After that, you will be responsible for all costs incurred. 

Medicare Advantage Plans will cover the same benefits as your Original Medicare, but costs won’t necessarily be the same.  For details on specific out-of-pocket costs, contact your plan directly.