You can think of Medicare Part A as your “room and board” in the hospital. It covers a semi-private hospital room with a bed, three meals per day, and the nurse that comes around to visit you. Furthermore, Part A pays for medications furnished to you by the hospital and any necessary lab services or medical supplies. However, before Medicare Part A pays anything, you must first pay Part A deductible of $1,484 in 2021.
Inpatient hospital care is covered by Medicare Part A when all of the following is true:
You are admitted to the hospital as an inpatient after an official doctor’s order, which says you need inpatient hospital care to treat your illness or injury.
The hospital accepts Medicare. In certain cases, the Utilization Review Committee of the hospital approves your stay while you are in the hospital.
According to CMS, the Part A inpatient hospital deductible covers your cost for the first 60 days of Medicare-covered inpatient hospital care. For example, you become an inpatient at a hospital in January 28 and pay Part A deductible. Then April 1 you get injured and become an inpatient again, you will need to pay the Part A deductible again.
In general, Medicare Part A covers:
After you have paid your Part A deductible of $1,484 in 2021, Part A pays for long-term care in a LTCH for the first 60 days of hospitalization. However, between 61 days and 90 days you pay $371 coinsurance each day in 2021. Furthermore, after 90 days you pay $742 coinsurance per each “lifetime reserve day” in 2021. After you are discharged from a LTCH, many people get care in a Skilled Nursing Facility or custodial care in a long-term care facility.
Medicare Part A pays for skilled nursing care provided by a SNF under certain conditions and for a limited time. Skilled care is nursing and therapy care that can only be safely and effectively performed by or under the supervision of professionals. It is healthcare given when you need skilled nursing or skilled therapy to treat, manage, observe your condition and evaluate your care.
Medicare Part A pays for up to 20 days of skilled nursing or therapy staff. However, you pay $185.50 coinsurance in 2021 for days 21 to 100. You pay all costs beyond 100 days.
Medicare Part A pays for your hospice care. However, you may need to pay a co-payment of no more than $5 for each prescription drug. For example, drugs for pain relief and symptom control while you are at home. Furthermore, you may need to pay 5% of the Medicare-approved amount for inpatient respite care.
Home health care is a wide range of health care services which are administered in your home for an illness or injury. For example, skilled home health care services include:
You must need and a doctor must certify that you need one or more of the following:
* Intermittent skilled nursing care (other than drawing blood)
* Physical therapy, speech-language pathology, or continued occupational therapy services.
Your condition must be expected to improve in a reasonable and generally predictable period of time. Furthermore, you must be homebound and a doctor must certify you are homebound. Moreover, your need for home health care must be part-time.
To find out if Medicare covers what you need, talk to your doctor or other health care provider. The following benefits are covered by Medicare Part A:
Medicare Part A covers blood you get as a hospital inpatient. In most cases, the hospital gets blood from a blood bank at no charge to you. However, if the hospital has to buy blood for you, you will need to pay hospital costs for the first 3 units of blood in a calendar year. Otherwise, you will need a blood donor.
As a hospital patient Medicare Part A cover blood transfusions.You may receive a blood transfusion to restore blood volume after a serious injury (hemorrhage). Furthermore, you can get blood transfusions to improve the oxygen carrying capacity of blood due to sever anemia.
Medicare Part A covers cancer treatment, including chemotherapy when you have cancer and are a hospital inpatient. When you are discharged from the hospital, you will need Medicare Part B to pay chemotherapy as a hospital outpatient or in a doctor’s office or clinic.
Medicare Part A pays for anesthesia services provided by a hospital if you are an inpatient. However, you will pay 20% of the Medicare-approved amount for the anesthesia services provided by a doctor or certified registered nurse anesthetist. Moreover, the anesthesia service must be associated with the underlying medical or surgical service. In addition, you may have to pay the facility a co-payment.
When you meet certain conditions related to morbid obesity, Medicare Part A will pay for some bariatric surgical procedures. For example, gastric bypass surgery and laparoscopic banding surgery.
Medicare Part A does not cover outpatient hospital service and prescription drug coverage. Learn more about Medicare Parts that cover these benefits.
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