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What does Medicare cover? Part A

Part A | Part B (Pages: 1 | 2 | 3)

Medicare health insurance has two parts, A and B. 

Part A, hospital insurance, covers the following services:

Hospitalization

Hospitalization includes semiprivate room and board, general nursing and other hospital services and supplies.  Also covered, up to 90 days inpatient healthcare in an approved psychiatric hospital.

The amount of Medicare coverage for hospitalization is based on the following benefit periods:

Benefit Medicare pays You Pay
First 60 days All but $1,156 $1,156
61st to 90th day All but $289 a day $289 a day
91st to 150th day* All but $578 a day $578 a day
Beyond 150 days Nothing All costs
* 60 reserve days may be used only once.

Skilled Nursing Facility Care

You must have been in a hospital for at least three days, enter a Medicare-approved facility generally within 30 days after hospital discharge and meet other program requirements. Medicare coverage for skilled nursing facility care is based on the following benefit periods:

Benefit Medicare pays You Pay
First 20 days 100% of approved amount Nothing
Additional 80 days All but $144.50 a day Up to $144.50 a day
Beyond 100 days Nothing All costs

Remember, neither Medicare nor Medicare supplement insurance will pay for most nursing home care.

Home Health Care

Home health care includes part-time or intermittent skilled care, home health services, physical and occupational therapy, durable medical equipment and supplies and other services.

Benefit Medicare pays You Pay
For as long as you meet Medicare requirements for home health care benefits 100% of approved amount; 80% of approved amount for durable medical equipment Nothing for services; 20% of approved amount for durable medical equipment

Hospice Care

Hospice care includes drugs for symptom control and pain relief, medical and support services from a Medicare-approved hospice, and other services not otherwise covered by Medicare. 
Hospice care is usually given in your home.

Benefit Medicare pays You Pay
For as long as doctor certifies need All but limited costs for outpatient drugs and inpatient respite care Limited cost sharing for outpatient drugs and inpatient respite care

Blood

Blood services are included when furnished by a hospital or a skilled nursing facility during a covered stay.

Benefit Medicare pays You Pay
Unlimited during a benefit period if medically necessary 80% of the Medicare-approved cost after the first 3 pints per calendar year For the first 3 pints then 20% of Medicare-approved cost for additional pints*
*To the extent the three pints of blood are paid for or replaced under one part of Medicare during the calendar year, they do not have to be paid for or replaced under the other part.

Part A | Part B (Pages: 1 | 2 | 3)

 

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