Medicare helps tens of millions of Americans get needed health care coverage in retirement. With coverage available at age 65 for most participants, the various parts of Medicare work together to provide comprehensive coverage for multiple types of health care needs. Under the traditional Medicare program, Part A provides hospital and inpatient care services.
Medicare Part A undergoes minor changes each year, and the government agency that runs the program recently announced what’s new for 2023. Here’s what participants can expect.
What Medicare Part A offers you
Medicare Part A coverage comes into play when you need a hospital stay or need to go to a skilled nursing facility. Under typical coverage, patients are covered for medically necessary hospital stays, providing them with a semi-private room and the medical treatment, services, tests and prescription drugs necessary to treat the patient’s condition. Patients also qualify to receive meals during their stays.
Medicare Part A is intended to provide the medical care necessary to fully resolve adverse health conditions. Stays of two days or more qualify for coverage, and the federal government funds extremely long stays, in many cases.
It’s important to understand that Medicare Part A does not cover long-term nursing home stays. However, skilled nursing care does qualify, although for inpatient facility costs to be covered, patients generally must have had a related hospital stay of at least three days. As with hospital stays, Medicare’s intent with its coverage of skilled nursing care is to address conditions and return participants to health.
Patients can also access some other services under Medicare Part A. These include home hospice care for terminally ill patients, as well as home care for other conditions when medically necessary.
Medicare Part A Costs
A great benefit of Medicare Part A is that most people are eligible to participate without paying a monthly premium. If you or your spouse contributed to the Medicare program through payroll withholding for at least 10 years, you generally won’t have to pay for Part A coverage.
Some people who do not have a full 10 years of work history will have to pay monthly premiums. Those who work between 30 and 39 quarters will pay $278 per month in 2023, $4 more than in 2022. Those with less than 30 quarters of eligible work history have to pay $506 per month, $7 more than prior year levels.
If you need to use your Part A coverage during the year, there are additional costs under the program. A deductible of $1,600 for 2023 is applied in advance before Medicare begins to cover the costs. That’s $44 higher than in 2022.
There are also copays for many Part A services. Once the deductible is met, Medicare provides full coverage for the first 60 days of a hospital stay. From days 61 to 90, the copay is $400 per day, $11 more than in 2022. Starting on day 91, you have 60 lifetime reserve days for which you’ll pay $800 per day in 2023, $22 more than in 2022 .
The cost structure for skilled nursing facility stays is similar. Copays are $0 for the first 20 days, and after days 21 through 100, patients are charged $200 per day. That’s an increase of $5.50 per day starting in 2022. Beyond the 100th day, Medicare no longer offers coverage.
Take advantage of Medicare Part A
Retirees should always consider health care costs as a key expense in their retirement planning. Medicare Part A covers many of those costs very well, but it doesn’t cover everything. By learning more about the program, you can more accurately plan for your overall finances in retirement.
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