What is the Part A Benefit Period?

Medicare Part A is known as Medicare’s hospital insurance. It covers inpatient healthcare services such as skilled nursing facility care, hospice care, and certain home healthcare services. If you are enrolled in Part A, there is something called the Part A benefit period, which you should know about when you first decide to enroll in Medicare. 

The benefit period measures how Medicare provides coverage if you are admitted as an inpatient at a hospital or skilled nursing facility. The amount you will cover for inpatient care will vary over the benefit period. The benefit period will end if you are not admitted into a skilled nursing facility or a hospital for at least 60 days after you have been discharged as an inpatient. 

Part A Benefit Period

The Part A benefit period applies to hospital stays, acute care, skilled nursing facility care, hospice care, and inpatient stays at a rehabilitation facility. For Part A, there is also the initial deductible you are expected to cover before you start to receive coverage for your Medicare costs. 

The deductible for Part A in 2021 is $1,484. After meeting this amount, Medicare will cover its share of the approved costs. If you are admitted as an inpatient at an approved facility, you will not pay any coinsurance during this benefit period for the first 60 days. After the 60th day up to the 90th day, you will pay $371 daily as coinsurance. The lifetime reserve days apply after the 90th day. Lifetime reserve days can be applied to multiple benefit periods. The coinsurance for each lifetime reserve day you use is $742. There are 60 lifetime reserve days, after which you’ll pay for all the costs during your inpatient stay that is longer than 90 days. 

If you haven’t been to the hospital or skilled nursing facility for 60 days as a Part A enrollee, you will start a new benefit period once the facility admits you as an impatient. After this, you’ll be required to meet your deductible again and then pay coinsurance costs after staying as an inpatient for 60 days. 

However, if you are discharged before staying for 60 days and get readmitted not long after, you will be in the same benefit period. This applies if you are readmitted to a facility within 60 days. It is important to note that there is no limit to benefit periods during the course of your Medicare coverage. 

Need Help With Out-Of-Pocket Costs?

To help cover your out-of-pocket expenses for Medicare Part A, you may consider enrolling in a Medicare Supplement (Medigap) plan. All ten Medigap plans will provide coverage for Part A coinsurance and hospital costs. Plans B, C, D, F, G, and N will cover 100% of your Part A deductible. Plans K and M will cover 50%, and Plan L will cover 75%.

Temmen Insurance provides specialized Medicare services based on your healthcare needs. For more information about Medicare Part A, contact us today.

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