If you are about to turn 65 years old or you want to get Medicare even though you missed the Initial Enrollment Period, it is important to know the prices and the things you will have to pay when you get Original Medicare. There are some ways in which you could pay less or some situations in which you will have to pay more than others. In this article we will explain everything about Medicare Part A costs.
Monthly Premiums of Medicare Part A
Most people don’t have to pay for Medicare Part A because they were eligible for a premium-free Part A when they enrolled to Medicare. This occurs when you join Medicare during your Initial Enrollment Period and you (or your spouse) have paid taxes during a specific period of time while working, accumulating at least 40 quarters of work.
You are also eligible for a premium-free Part A if you are under 65 years old and you got Social Security or Railroad Retirement Board benefits for 24 months or you have End-Stage Renal Disease (ESRD).
If you are not eligible for premium-free Part A, you will have to pay for Medicare Part A. Depending on the amount of quarters you have accumulated, the amounts may vary. In 2018, the standard Part A premium is $422 in case you paid Medicare taxes for less than 30 quarters, and it is $232 in case you paid Medicare taxes from 30 to 39 quarters.
Part A late enrollment penalty
If you did not sign up for Medicare when you were first eligible (during your Initial Enrollment Period), you have to pay the late enrollment penalty. In this case, you monthly premiums will go up 10% and you will have to pay that extra percentage for twice the number of years you could have Medicare but you did not sign up.
For example, you were eligible for premium-free Part A during 1 year but you did not sign up, so you will have to pay the higher premium for 2 years.
As it was explained in another article, there are certain situations if which you could still get premium-free Part if you do not sign up when you were first eligible. This is called “special enrollment period”. For more details on Medicare plans for 2019 go to http://www.Medigapplansguide.com
Part A hospital inpatient deductibles and Coinsurances
Although you may pay monthly Part A premiums, you will have to pay for the rest of Medicare Part A costs, which are deductibles and coinsurance. Remember a deductible is the amount of money you have to pay for healthcare services before Medicare starts paying, and a coinsurance is your share of the costs of a health service. You start paying the coinsurance after you pay the deductible.
In 2018, the deductible is $1340 for each benefit period. From days 1 to 60, you don’t pay anything for coinsurance for each benefit period; from days 61 to 90 the coinsurance is 335$ per day of each benefit period; from days 91 and beyond the coinsurance is $670 per each “lifetime reserve day” for each benefit period and up to 60 days over your lifetime. You will also have to pay all costs of you beyond lifetime reserve days.
A benefit period starts the day you enter a hospital or Skilled Nursing Facility (SNF) and ends when you have not received inpatient hospital care for 60 non-calendar days in a row. After those 60 days, a new benefit period begins. While you are in the hospital or SNF, you will have to pay the daily coinsurance.
As Original Medicare only cover up to 90 days of inpatient care each benefit period, you get a coverage of 60 days more, called lifetime reserved days, and they can be used only once. For example, if you spent 140 days in the hospital, you will have used 50 days from your lifetime reserved days, so you will have only 10 lifetime reserve days covered by Medicare if you have to spend more than 90 days in the hospital in the future.