Medicare Part A

Medicare Part A covers your inpatient care in a hospital or skilled nursing facility as well as hospice and home health care. Part A measures your care in benefit periods, which span from admittance to an absence of care for 60 days.

You pay Part A deductibles for each benefit period. One upside of Part A is that the majority of Medicare beneficiaries do not pay premiums for Part A. If you have any questions about hospital insurance or if you qualify for premium-free Part A, ask Serenity, your local agent at Almond Insurance.

Part A Coverage

Part A covers inpatient care in a hospital, skilled nursing facility care, nursing home care, hospice care, and home health care. What’s covered is based on state and federal law, national coverage decisions, and decisions by your state Medicare claims processing companies. If you want to know whether an item, test, or service is covered, you can go to Medicare’s website and use their helpful search tool.

Medicare Part A does not cover long-term or custodial care in a nursing home or skilled nursing facility. For help paying for your long-term care costs, you can look into annuities or long-term care insurance plans or speak with a financial advisor. If your income is low enough, you may qualify for assistance through Medicaid.

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Part A Costs

To receive your Part A coverage, you will need to pay monthly premiums. You will also need to pay deductibles and coinsurance for the care you receive.

The 2021 Part A deductible is $1,484 for each benefit period. A benefit period begins when you’re admitted as an inpatient and ends when you have not received inpatient care for 60 days.

After a certain number of days have passed while you are an inpatient, you’ll need to pay a daily coinsurance. Between days 61 and 90 as a hospital inpatient, you’ll owe $371 in coinsurance in 2021. After day 90, you have 60 lifetime reserve days during which you owe $742 each day. Once you have spent your lifetime reserve days, you owe all costs.

Premium-Free Part A

Most people are eligible for Part A with no premiums. The following are eligible for premium-free Part A:

  • People who or whose spouse worked at least 40 calendar quarters while paying taxes to Social Security
  • People who already receive retirement benefits from Social Security or the Railroad Retirement Board when they turn 65
  • People who are eligible for retirement benefits but haven’t filed for them yet
  • People who had Medicare-covered government employment
  • People who qualify due to a disability and have received disability benefits for 24 months
  • People with End-Stage Renal Disease who need regular dialysis or have had a kidney transplant AND meet at least 1 of the following:
    • Have worked at least 40 calendar quarters paying taxes to Medicare 
    • Are already receiving or are eligible for retirement benefits
    • Are the spouse or dependent child of someone who meets those criteria

If you are buying Part A, you’ll pay $471 each month in 2021 if you have fewer than 30 work credits and $259 if you have between 30 and 39 work credits (calendar quarters worked while paying taxes to Medicare).

If you are in the Northern Illinois area, contact me today to find out if Medicare Part A is best for you!