Medicare Part A Benefits and Costs

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Medicare Part A helps pay for:

  • Hospital inpatient care
  • Skilled nursing facility care (SNF) — not custodial or long-term care
  • Home health care
  • Blood for transfusions
  • Hospice care

Part A is premium free if you or your spouse have worked and paid social security taxes for at least 40 quarters or 10 years.

Inpatient Hospital Benefits and Costs

Benefits are paid on the basis of “benefit periods”. A benefit period begins the first day you are hospitalized and ends when you have been out of a hospital or skilled nursing facility for 60 consecutive days.

Paying for Hospital Care in 2016 – for each benefit period you pay:

  • $1,316 deductible, paid upon admission as a hospital inpatient for days 1-60.
  • $329 per day for days 61-90
  • $658 per day for days 91-150

Each beneficiary has 60 lifetime reserve days

Skilled Nursing Facility (SNF) Benefits and Costs

You must meet all the following conditions:

  • Require daily skilled services
  • Been hospitalized for at least 3 consecutive inpatient overnights prior to SNF admission
  • Admitted to SNF within 30 days after leaving hospital
  • Receive care in the SNF for the condition treated in the hospital.
  • The SNF must be a Medicare participating SNF.

SNF costs for 2015

  • Days 1-20 covered in full (if medically necessary)
  • Days 21-100 beneficiary is responsible for $161 per day
  • No custodial or intermediate nursing home care provided

Home Health Care Benefits and Costs

Must meet the following four conditions:

  • Must be under the care of a doctor
  • Must need skilled services
  • Must be homebound
  • Must use a Medicare approved agency

Prior hospitalization is not required to receive home health services under Medicare. There are typically no copayments for approved home health care services. Durable Medical Equipment (DME) carries a 20% coinsurance.

Hospice Care Benefits and Costs

Hospice Care is special care for people who are terminally ill and for family respite care. Medicare pays for a maximum of 210 days of care in a Medicare approved hospice program, through two 90 day periods and one 30 day period.

There are no deductibles or co-payments except for covered drugs and inpatient respite care. You must elect Hospice Care to receive these benefits.

Part A Resources