Medicare Part A
Most people refer to Medicare Part A as the "Hospital" part but there is more to the story. Skilled Nursing Facilities and Hospice care are also included in your Medicare Part A coverage.
Hospital Stays
Days 1 - 60
If you are admitted to the Hospital you have a benefit period deductible of $1,600.
Medicare defines a "benefit period" as the period which begins the day you’re admitted as an inpatient in a hospital or SNF. The benefit period ends when you haven’t gotten any inpatient hospital care (or skilled care in an SNF) for 60 days in a row.
If you are admitted into a hospital or SNF after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period.
There’s no limit to the number of benefit periods.
Days 61 - 90
After you have been admitted to the hospital for more than 60 days in one benefit period, you are now responsible for a $400 per day co-payment.
If you stay the full 30 days the co-payments will total $12,000.
Days 91 - 150
If you have an extended day that is over 90 days you are now responsible for a $800 per day co-payment.
If you stay the full 60 remaining days your co-payments will total $48,000.
Medicare has also included a limit on the use of these days, they are labeled your "Lifetime Reserve Days" and once they are used they can never be used again.
Days 150+
If your hospital stay exceeds 150 days in one benefit period Medicare stops paying and you are now responsible for 100% of your hospital bills.
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Skilled Nursing Facilities
Days 1 - 20
Following an inpatient hospital stay of at least 3 days and enter a skilled nursing facility within 30 days after hospital discharge and receive skilled nursing care. All eligible expenses for the first 20 days.
Days 21 - 100
You have a $200 per day co-payment, then all eligible expenses for days 21-100 after the patient pays a per-day copayment. If you stay the full 80 days you will be responsible for $16,000.
Hospice
Who is Hospice for?
Hospice care is for people with a life expectancy of 6 months or less (if the illness runs its normal course). If you live longer than 6 months, you can still get hospice care, as long as the hospice medical director or other hospice doctor re-certifies that you are terminally ill.
What is covered?
Your hospice benefit covers care for your terminal illness and related conditions. Once you start getting hospice care, your hospice benefit should cover everything you need related to your terminal illness.
Stop Hospice?
If your health improves or your illness goes into remission, you may no longer need hospice care.
You always have the right to stop hospice care at any time. If you choose to stop hospice care, you will be asked to sign a form that includes the date your care will end.
Medicare Open Enrollment
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Last updated: 01.05.2023 at 12:01 AM MULTIPLAN_SHDLEAWE002_M