No one ever plans to be hospitalized, but for many enrolled in Medicare Part A it is a relief for them to know that this part of Original Medicare will cover some of the expenses they will incur during their hospitalization. Medicare Part A is often referred to as Hospital Insurance and this part of Medicare helps pay for the care you receive if you are admitted as an inpatient in a hospital or skilled nursing facility.
Included in these hospital services are semi-private rooms, meals, general nursing, and medication and supplies needed for your care during your inpatient stay. That includes the care you receive in facilities such as:
- Acute Care Hospitals
- Critical Access Hospitals
- Inpatient Rehabilitation Facilities
- Long Term Care Hospitals
- It also includes inpatient care as part of a qualifying clinical research study and
- Health Care given in a psychiatric hospital or other hospital
Who is eligible to have these services covered?
All people enrolled in Part A are covered when this is true:
- A doctor makes an official order which says that you need 2 or more midnight's of medically necessary treatment for your illness or injury and you are formally admitted into the hospital.
- You need the kind of care that can only be administered in a hospital
- The hospital accepts Medicare
- The Utilization Review Committee of the hospital approves your stay while you are in the hospital.
Your Costs with Original Medicare:
- $1,364 deductible for each benefit period
- Days 1-60: $0 coinsurance per each day of each benefit period
- Days 61-90: $341 coinsurance per day of each benefit period
- Days 91 and beyond: $682 coinsurance for each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
- Beyond lifetime reserve days you will be responsible for all costs
What is not covered under Part A:
- Private duty nursing
- Private Rooms (unless medically necessary)
- Television and phone in your room if there is a separate charge for these items
- Personal care items such as razors or slipper socks
- Costs also may not be covered by Part A if you are only in the hospital for observation