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 copay (coinsurance).

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 for 10 years, and made at least $5,200 per year and are a U.S. Citizen.

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

  • If you worked fewer than 7.5 years you will pay $422/mo.

MONTHLY PREMIUM:

DEDUCTIBLE:

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

With Medicare A, you have a $1,340 deductible for each “benefit period” . What is a benefit period, you may ask? If you go to the hospital, are discharged and remain unhospitalized for 60 days, a new benefit period starts. For example, if you are hospitalized in January, released mid-January, and then hospitalized in August you would pay the deductible AGAIN. In the same year.


COINSURANCE:

Coinsurance: 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 during a 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 x 30 or 20k. AND you will have used up 30 of your “lifetime reserve days.”

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

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

  • Beyond lifetime reserve days: pay all costs out-of-pocket.