Medicare is federally funded health insurance for people age 65 and older and individuals with qualifying medical conditions. Medicare Part A is hospital insurance that covers eligible hospital and skilled nursing facility costs. The Medicare Part A deductible is the amount that you pay before Medicare starts to pay the costs.
Benefit Periods
To understand the Medicare Part A deductible, you first need to understand benefit periods. A benefit period begins on the day you go into a hospital or skilled nursing facility. If your stay in a hospital or skilled nursing facility is less than 60 consecutive days, the benefit period ends. If you go into a hospital or skilled nursing facility after the end of a benefit period, a new benefit period begins.
Part A Deductible
You pay a Medicare Part A deductible for each benefit period. In 2011, the deductible was $1,132.
Part A Hospital Coverage
During each benefit period, Part A covers a semiprivate hospital room, meals and eligible hospital services for up to 90 days. After you pay the deductible, Medicare pays all covered charges for the first 60 days you are in a hospital. From day 61 through 90, you pay coinsurance of $283 a day. After 90 days, you pay all hospital charges, unless you have not used your 60 lifetime reserve days.
Reserve Days
Medicare Part A gives you 60 lifetime reserve days that will pay for hospital costs beyond the usual 90-day limit. You can use these reserve days any time you are in the hospital for more than 90 days; but once you use the 60 reserve days, you do not get any more. With reserve days, you pay coinsurance of $566 a day.
Nursing Facility Coverage
If you have a covered hospital stay of at least three days and then go into a skilled nursing facility, Medicare pays all eligible nursing facility costs for the first 20 days during that benefit period. For days 21 through 100, you pay coinsurance of $141.50 a day. You pay all costs after day 100.
Tags: benefit period, Medicare Part, skilled nursing, skilled nursing facility, hospital skilled, hospital skilled nursing
