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Medicare Part A (hospital insurance) covered services
Part A premium:
- For most people, Part A is free.
- If you have fewer than 30 working quarters of coverage, you pay $426/month.
- For 30-39 working quarters of coverage, you pay $234/month.
Your benefit period for hospitalization and skilled nursing facility care:
- It starts the first day you receive a Medicare-covered service as an inpatient in a qualified hospital.
Note: Just because you're in a hospital does not mean you qualify as an inpatient.
- It ends when you have been out of a hospital (or other facility that provides skilled nursing or rehab services) for 60 days in a row.
- It also ends if you stay in a facility (other than a hospital) that provides nursing or rehab services, but don't receive any skilled care there for 60 days in a row.
- If you enter a hospital again after 60 days, a new benefit period starts.
|Services||Benefit||Medicare pays||You pay|
|First 60 days||All but $1,216||$1,216 (For each benefit period) $0 coinsurance for each benefit period|
|61st to 90th day||All but $304/day||$304/day (Coinsurance per day for each benefit period)|
|91st to 150th day (60 reserve days may be used only once||All but $608/day||$608/day (Coinsurance per each "lifetime reserve day" after day 90 for each benefit period. Up to 60 days over your lifetime)|
|Beyond 150 days (Lifetime reserve days)||Nothing||All costs|
Skilled nursing facility care
(Not custodial or long-term care)
|First 20 days||100% of approved amount||Nothing|
|Next 80 days||All but $152/day||Up to $152/day|
|Beyond 100 days||Nothing||All costs|
Home health services
(A doctor or certain health care providers who work with a doctor, must see you face-to-face before a doctor can certify that you need home health services.)
|Unlimited as long as you meet Medicare requirements for home health care benefits||
100% of approved amount
80% of approved amount for durable medical equipment
Nothing for services
20% of approved amount for durable medical equipment
|For as long as doctor certifies need||All but limited costs for outpatient drugs and inpatient respite care||Limited cost sharing for outpatient drugs and inpatient respite care|
When furnished by a hospital or skilled nursing facility during a covered stay
|Unlimited during a benefit period if medically necessary||All but first three pints per calendar year||For first three pints|