Medicare Part A – Hospital Insurance

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Part A pays for most inpatient hospital care, some care in a skilled nursing facility, some home health services, and hospice care.

There is no monthly Part A premium if you who have 40 or more quarters of Social Security credits (about 10 years of full-time work with four quarters per year) and you are eligible for Social Security or Railroad Retirement benefits. If you have 30-39 Social Security quarters you may buy Part A and pay a monthly premium of $233 in 2008. If you have fewer than 30 Social Security quarters, you may purchase Part A and pay a monthly premium of $423 in 2008.

Inpatient hospital care

Medicare covers up to 90 days of inpatient hospital services in each "benefit period," plus an additional 60 "lifetime reserve days."

A benefit period begins when a beneficiary is admitted to the hospital and ends when the beneficiary has been out of the hospital for 60 days, or has not received Medicare-covered care in a skilled nursing facility (or hospital) for 60 consecutive days since the day of discharge.

Lifetime reserve days are 60 days of inpatient hospital coverage that Medicare gives you to cover your costs after a 90-day stay in the hospital. These 60 lifetime reserve days can be used only once — if you use up any of these 60 lifetime reserve days, Medicare will not renew those days. (Very few people remain in a hospital for 150 consecutive days. In the rare event this happens, almost every Medigap policy contains a benefit for another 365 hospital days during your lifetime.)

The inpatient hospital deductible and co-payments in 2008 are as follows:

• A $1,024 deductible for the first day you are a hospital inpatient. This single deductible covers the next 59 days in the hospital for the same benefit period.
• After you have been in the hospital for 60 days, you must pay a co-payment of $256 per day for days 61-90.
• From the 91st day through the 150th day you are hospitalized, you must pay a $512 per day co-payment for each of the 60 lifetime reserve days.

Medigap policies are designed to pay for these co-payments and an additional 365 days of hospital care during your lifetime. Some policies also pay the deductible.

Care in a skilled nursing facility

Medicare covers up to 100 days of care in a skilled nursing facility for each benefit period if all of Medicare's requirements are met, including that you required daily skilled nursing care and you have had three days of prior hospitalization.

Medicare pays in full for the first 20 days of a covered stay. A co-payment of $128.00 (in 2008) is required for days 21-100 if Medicare continues to pay for your stay.

Home health services

Medicare covers up to 100 home health visits per spell of illness following a hospital stay under the Part A benefit. Additional home health benefits are available under Part B benefits. Home health visits under both parts of Medicare must meet the following conditions:

• A physician has certified that the patient is homebound.
• There is a need for intermittent skilled nursing or therapy services.
• Services are provided by a Medicare-certified home health agency.

Hospice care

Hospice care is available for terminally ill patients. The goal of hospice care is to keep the patient as comfortable as possible. It does not provide treatment for the condition causing the terminal illness.

2008 Premiums, Co-insurance & Deductibles (Original Fee-for-Service Medicare)

See also:

• Medicare Part B
• Enrolling in Medicare Parts A and B

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Page updated July 24, 2008