Understanding Medicare Part A Costs
Medicare Part A is hospital insurance for Medicare beneficiaries. In addition to inpatient care in hospitals, Part A helps cover care in skilled nursing facilities, hospice care, and home health care. What beneficiaries pay for Medicare Part A each year will vary based on what coverage and services you access, and what providers you visit. There's also no yearly limit on out-of-pocket expenses for Part A, unless you have supplemental coverage such as a Medigap plan or you join a Medicare Advantage Plan. Let’s take a look at Medicare part A costs.
Understanding Medicare Part A Costs
Here’s what you need to know about Medicare Part A costs:
Most people pay no monthly premium for Part A because they or their spouse paid Medicare taxes long enough while working (typically at least 10 years). This scenario is commonly referred to as “premium-free Part A.”
If you don’t qualify for premium-free Part A, you still might be able to buy it. In 2023, the monthly premium is either $278 or $506, depending on how long you or your spouse worked and paid Medicare taxes.
One thing to remember is that in order to buy Part A, you will need to sign up for Part B (medical insurance).
Part A late-enrollment penalties
If you don’t buy Part A when you’re first eligible for Medicare (usually when you turn 65), you might pay a penalty. Your monthly premium could go up 10% for twice the number of years you didn't sign up.
Part A deductible
The 2023 Part A deductible for each inpatient hospital benefit period is $1,600. The deductible is the amount that beneficiaries must pay before Medicare starts to pay.
It’s important to know that there’s no limit to the number of benefit periods you can have in a year. The Part A benefit period starts the day you're admitted as an inpatient and ends when you haven't gotten any inpatient hospital care for 60 days in a row.
Costs for hospital inpatient stay
After the deductible is met, this is what a patient will owe for inpatient stays:
Days 1-60: $0
Days 61-90: $400 copayment each day
Days 91-150: $800 copayment each day while using your 60 lifetime reserve days
After day 150: You pay all costs.
Medicare does not cover the cost of:
Television in your room
Phone in your room
A private room, unless it's medically necessary
Cost for skilled nursing facility stay
Days 1-20: $0 copayment
Days 21-100: $200 copayment each day
Days 101 and beyond: You pay all costs
Cost for home health care
$0 for covered home health care services
Durable medical equipment such as wheelchairs, walkers, hospital beds are covered at 80% so you will pay 20% coinsurance
Cost for hospice care
$0 for covered hospice care services
A copayment of up to $5 for each prescription for pain relief and symptom control while you're at home. If your hospice care doesn't pay for your prescription drugs, ask your provider to contact your Medicare drug plan (if you have one) to see if they will cover it.
5% of the Medicare-approved amount for inpatient respite care
Remember: Medicare doesn't cover room and board when you get hospice care in your home or in a facility where you live (like a nursing home).
If you have any specific questions about how Part A will be applied in your situation, please give us a call. We are happy to help!
Our independent insurance agents are dedicated to assisting people on Medicare and those who are ready to transition from employer coverage to personal retirement coverage. We help kupuna understand their benefits options and apply for additional coverage, as needed. We are the only insurance agency in Hawaii contracted with EVERY Medicare Advantage plan, which means we are able to offer unbiased advice; all at no cost to our clients.
At PBC, our clients are our number one priority and we look forward to getting to know you and your needs. Call us today at (808) 738-4500 to see how we may be of assistance.