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Medicare Part A

What Does Medicare Part A Cover?

Medicare Part A covers hospitalization services from healthcare providers who accept Original Medicare coverage. Examples of hospitalization services include surgery, inpatient rehabilitation services, skilled nursing facility care, and hospice.

Medicare Part A Enrollment

To be eligible for premium-free Part A: An individual who is receiving monthly Social Security or RRB benefits at least 4 months prior to turning age 65 does not need to file a separate application to become entitled to premium-free Part A. In this case, the individual will get Part A automatically at age 65.

People who must pay a premium for Part A do not automatically get Medicare when they turn 65. They must:

  • File an application to enroll by contacting the Social Security Administration;
  • Enroll during a valid enrollment period;
  • Also enroll in or already have Part B.

When will my Medicare Part A coverage start?

Part A coverage begins the month the individual turns age 65, provided he or she files an application for Part A (or for Social Security or RRB benefits) within 6 months of the month in which he or she becomes age 65. If the application is filed more than 6 months after turning age 65, Part A coverage will be retroactive for 6 months.

NOTE: For an individual whose 65th birthday is on the first day of the month, Part A coverage begins on the first day of the month preceding their birth month. For example, if an individual's birthday is on December 1, Part A begins on November 1.1

How Much Does Medicare Part A Cost?

Medicare Part A Deductible 2017

The deductible for Medicare Part A is not like most medical deductibles. Most medical deductibles apply once per year. The deductible for Medicare Part A is different. Medicare Part A has a deductible for each benefit period you experience. A Medicare Part A benefit period begins when a Medicare enrollee is admitted as an inpatient to a hospital or skilled nursing facility. The period ends when this enrollee has not been an inpatient at either a hospital or a skilled nursing facility for a continuous 60-day period. Because of the Part A deductible’s relationship to a benefit period instead of a year, a Medicare enrollee can face multiple benefit periods (and Part A deductibles) within a single calendar year.

In 2017, the Medicare Part A deductible amount is $1,316(compared with $1,288 in 2016).

Medicare Part A Co-Insurance Fees 2017

Co-insurance is a percentage of medical costs paid out-of-pocket by the patient as opposed to the insurance plan. Medicare Part A charges co-insurance fees for inpatient healthcare. The 2017 co-insurance fees for Medicare Part A inpatient care is as follows:

  • Days 1-60 as an inpatient: $0 co-insurance for each benefit period
  • Days 61-90 as an inpatient: $329 co-insurance per day of each benefit period
  • Days 91 (and higher) as an inpatient: $658 co-insurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime)
  • Beyond lifetime reserve days: all costs paid by patient

For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $164.50 in 2017 ($161 in 2016).

Medicare Part A Premium 2017

Most people who are eligible for Medicare Part A do not have to pay a premium. If you or your spouse paid Medicare taxes while working, it is unlikely that you will have to pay for Medicare Part A.

However, for those people that are obligated to pay a premium, Part A can cost up to $413 a month in 2017. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $413. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $227. Typically, if you buy Medicare Part A, you must also buy Medicare Part B.

Sources:

1 https://www.cms.gov/Medicare/Eligibility-and-Enrollment/OrigMedicarePartABEligEnrol/index.html



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