What is the cost of Medicare Part A?
Medicare Part A pays most of the cost for hospital stays lasting up to 60 days. But if you have a very long stay, you can expect to pay a large share of the cost. You will pay a deductible for each benefit period and a daily co-payment after day 60 of each benefit period in the hospital. If you are in the hospital longer than 90 days in a benefit period, you may pay even more.
Part A is premium free if you or your spouse worked and paid Medicare taxes for at least 10 years. There are no limits on your out-of-pocket spending with Part A. Your expenses could be substantial if you have a chronic condition or serious illness.
2015 Part A Costs
- $0 for most people
- Up to $407 per month, if applicable
- $1,260 per benefit period
- $0 per day for inpatient hospital days 1-60 of each benefit period
- $315 per day for inpatient hospital days 61-90 of each benefit period
- $630 per day for lifetime reserve day 91 and beyond of each benefit period (up to a maximum of 60 days over your lifetime)
- $0 per day for skilled nursing facility days 1-20 of each benefit period
- Up to $157.50 per day for skilled nursing facility days 21-100 of each benefit period
- All costs for skilled nursing facility days 101 and beyond of each benefit period
- Up to $5 per prescription for medications for pain and symptom management during hospice care
- 20% of the cost for durable medical equipment used at home, such as a walker or wheelchair
- 5% of the Medicare-approved amount for short-term hospice care given by another caregiver, so the usual caregiver can rest
How does this work?
A benefit period begins when you enter the hospital and ends when you have been out of the hospital for 60 days in a row. If you’re in and out of the hospital several times within a few weeks for the same condition, that’s still one benefit period.
If your hospital stay lasts longer than 60 days in a benefit period, then you’ll pay a substantial co-payment for each day between days 60 and 150.
Medicare Part A limits coverage for hospital stays longer than 90 days in a benefit period. When you enroll in Part A, you get a “lifetime reserve” of 60 days. Each time you stay in a hospital more than 90 days in a benefit period, you can use lifetime reserve days to cover the additional days.
Once you’ve used up your lifetime reserve, Part A will help pay only for the first 90 days per benefit period of any hospital stay. And that’s subject to the normal deductibles and co-pays. After 90 days, you’re responsible for paying for your own care. Medicare Part A also limits the number of days in a psychiatric hospital it will pay for during your lifetime.
Here are some examples.
Julie’s story: A short hospital stay
Hector’s story: Two hospital admissions, one benefit period
Margaret’s story: Two hospital admissions, two benefit periods
Juan’s story: A long hospital stay