Medicare Part A is a part of Original Medicare that primarily covers inpatient hospital care, skilled nursing facility care, hospice care, and home health care. As with most insurance plans, Medicare Part A has certain deductibles and copayments that beneficiaries are responsible for paying before Medicare coverage kicks in. In this article, we will focus on the Part A deductible and how it works.
What is the Medicare Part A Deductible?
The Medicare Part A deductible is a set amount that beneficiaries must pay out of pocket before Medicare begins to pay for certain covered medical expenses. In 2024, the Part A deductible is $1,632. This deductible typically applies to each "benefit period."
What is a Benefit Period?
A benefit period begins on the first day that a beneficiary receives inpatient hospital care and ends when they have been out of the hospital or skilled nursing facility for 60 consecutive days. In other words, a benefit period can last for much longer than 60 days if a beneficiary requires multiple hospital stays or skilled nursing facility stays within a 60-day period.
How Does the Part A Deductible Reset Every 60 Days?
The Part A deductible resets every 60 days, which means that beneficiaries will need to pay the deductible again if they require inpatient hospital care after the end of a benefit period. Benefit periods in Medicare work as follows: Days 1-60 require payment of the Part A deductible, then $0 for covered services. Days 61-90 entail a daily copayment of $400 ($408 in 2024). After 90 days, Original Medicare covers additional hospitalization days.
Here’s a breakdown of the daily out-of-pocket costs after you’ve met your Part A deductible:
Length of Stay
$0 after $1,632 Deductible
first 60 days of inpatient hospital care
$408 copayment each day
$816 copayment each day
all costs after 150 days
after you've used all 60 lifetime reserve days
Medicare Part A carries out-of-pocket costs for patients seeking inpatient treatments or care. Unlike Part B, there is no cap on these expenses. After paying the annual deductible ($1,632 in 2024), patients pay daily costs varying by how long they’ve been hospitalized.
How Do Medicare Supplement Plans Cover the Part A Deductible?
Medicare Supplement plans, also known as Medigap plans, are designed to help cover certain costs that Original Medicare does not cover. There are ten different Medigap plans, each labeled with a letter (A, B, C, D, F, G, K, L, M, N), and each plan provides a different set of benefits.
Of these ten Medigap plans, only two plans cover the Part A deductible: Plan F and Plan G. Plan F is a comprehensive Medigap plan that covers not only the Part A deductible but also Part B deductible and Part B excess charges. However, this plan is not available to new Medicare beneficiaries who became eligible for Medicare on or after January 1, 2020. Plan G is now the most comprehensive Medigap plan and covers most out-of-pocket costs for beneficiaries, including the Part A deductible.
How Does the Part A Deductible Work with Medicare Advantage (Part C)?
Medicare Advantage (Part C) plans are an alternative to Original Medicare that are offered by private insurance companies. These plans are required to cover everything that Original Medicare covers, and often offer additional benefits such as vision, hearing, dental, and prescription drug coverage.
Medicare Advantage plans vary in their cost-sharing structures, but they are required to have a Maximum-out-of-Pocket (MOOP) limit each year. The MOOP is the most that beneficiaries are required to pay out of pocket for covered services. Once a beneficiary reaches their MOOP limit, the plan is required to cover all additional costs for covered services for the remainder of the year.
Many Medicare Advantage plans do not have a deductible for inpatient hospital stays. However, if a plan does have a deductible, it may be lower than the Part A deductible for Original Medicare. For example, in 2024, some Medicare Advantage plans will have a deductible as low as $300.
Not Having Proper Coverage Can Lead to Financial Burdens
If you do not have proper coverage for your healthcare needs, you may be burdened with high out-of-pocket costs. The Part A deductible, in particular, can be a significant expense for beneficiaries who require multiple hospital stays within a benefit period.
Having a Medicare supplement plan that covers the Part A deductible, such as Plan G, can help pay this deductible and reduce your out-of-pocket expenses in the event of a hospital stay. Additionally, if you choose a Medicare Advantage plan with a lower MOOP than the Part A deductible, you can reduce the financial hardship that hospital or multiple hospital stays can create.
Reviewing Coverage Options with Lehigh Partners Senior Benefits
If you are approaching Medicare age or considering switching plans, it's important to review your coverage options carefully. Choosing the right plan can help you better manage potential healthcare expenses and give you greater peace of mind.
At Lehigh Partners Senior Benefits, we offer free consultations to help you review your options and make informed decisions. Our team of authorized Medicare agents can help you find the Medicare supplement plan or Medicare Advantage plan that meets your unique healthcare needs and budget. Contact us today to schedule your no-cost consultation and ensure better coverage for all your healthcare needs.