Medicare Part A Deductible

Medicare was designed with the goal of providing all senior citizens in America with reliable and affordable health care coverage. The program also strives to provide senior citizens with quality coverage and while the program eliminates many costs associated with health care for seniors, the system still has premiums, co-insurances, and deductibles that beneficiaries must pay out of pocket.

Medicare’s Part A coverage provides seniors with hospital insurance to cover expenses involved in inpatient treatment at a hospital facility. Part A also covers beneficiaries who require a stay in a skilled nursing facility, hospice, and even some in-home health services.

When it comes to hospital coverage, beneficiaries will have to help cover some of the costs as Medicare will not pay for everything. In addition, Medicare will only help pay for expenses related to a hospital stay for a certain period of time before the costs become the full responsibility of the beneficiary. Medicare Part A deductibles work as follows, during a hospital stay:

- Beneficiary pays deductible of $1,100 during days 1-60 of hospital stay

- Beneficiary then pays $275 per day for days 61-90 of hospital stay

- Beneficiary then pays $550 per day for days 91-150 of hospital stay

After the initial Part A deductible has been paid by the beneficiary during the first 60 days, Medicare will cover all other costs associated with a room, meals, doctor and nursing services, treatment, and exams. If a beneficiary needs to stay in the hospital beyond 150 days, or returns to the hospital with less than 60 days between visits and exceeds the 150 days in the process, they must pay the full cost of their treatment expenses.

At the beginning of each benefit period, the Medicare Part A deductible must be paid by beneficiaries. A benefit period extends from the day a patient is admitted to the hospital until the final day treatment is received. If a beneficiary goes 60 days in a row without receiving treatment, the benefit period restarts and a deductible will have to be paid again if treatment is necessary.

The other portion of health care that Medicare Part A covers generally doesn’t require a deductible to be paid first. After a certain period of time, beneficiaries who require a stay in a skilled nursing facility will have to pay out of pocket for their stay. These costs include:

- No out of pocket costs during first 20 days of stay

- $137.50 (as of 2010) for each day during days 21-100 of stay

- Full burden of expenses for all days after 100 falls on beneficiary

Beneficiaries who require in-home health services or stay in a hospice will face no deductible from their Part A coverage. The only out of pocket costs associated with Part A coverage for home health services and hospice stays involve premiums for medication and durable medical goods.

Medicare strives to pay for as much of the cost involved in a senior citizens health care as possible, but the system does have deductibles that must be met first before full coverage kicks in. While a deductible of $1,100 might seem high that cost in comparison to the full burden of paying for hospital related expenses is often minimal.