Annual costs of Medicare A


This type of Medicare covers your hospital bills.

In any given year you could pay nothing for Medicare A if you are never hospitalized. If you are hospitalized then you have to pay a deductible and a co-pay (co-insurance).

You monthly out of pocket costs: For most people this amount is zero. You most likely won’t have to pay this monthly fee out of pocket.

You won’t have to pay out of pocket if you worked 10 years and made at least $5200 a year and are a US Citizen.

  • If you only worked 7.5-9.5 years then you will pay about $232/mo.

  • If you worked less than 7.5 then it is $422/mo.

MONTHLY PREMIUM:

DEDUCTIBLE:

Deductible: What you pay when you have to go to the hospital before insurance kicks in.
So this deductible is not like a normal deductible. It can happen multiple times in a year if you are hospitalized multiple times.

$1,340 deductible for each “benefit period” . What is a benefit period, you may ask? If you go to the hospital and then are discharged and are not in the hospital for 60 days, then a new benefit period starts. So if you get hospitalized in January and are released mid-January and then are hospitalized in August you would pay the deductible AGAIN. In the same year.


CO-INSURANCE:

Co-insurance: What you pay out of pocket AFTER you pay the deductible.

  • Days 1-60: $0 coinsurance for each benefit period (remember the benefit periods are not annual)

  • Days 61-90: $335 coinsurance per day of each benefit period

  • Days 91 and beyond: $670 coinsurance per “lifetime reserve” day

    • You only get 60 of these “lifetime reserve days”.

    • Even we are confused. So what does this mean?

    • Let’s say you are hospitalized for 120 days. You would pay nothing for days 1-60. Day 61-90 you would pay $335 x 30 days or about $10k. For days 91-120 you would pay another $670* 30 or $20k. BUT you will have used up 30 of your “Lifetime reserve days”

    • If the next year you were hospitalized AGAIN for 120 days you would have no more Lifetime reserve days because you only get 60.

    • If the next year you were hospitalized yet AGAIN for 120 days then the last 30 of those days you would pay full pop for the hospital. Yikes.

  • Beyond lifetime reserve days: all costs