Medicare Part A (Hospital Insurance) covers inpatient hospital care when all of these are true:
- You’re 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’re in the hospital.
The Cost to you? You pay this:
- $1,408 deductible for each benefit period .
- Days 1–60: $0 coinsurance for each benefit period.
- Days 61–90: $352 coinsurance per day of each benefit period.
- Days 91 and beyond: $704 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime).
- Beyond lifetime reserve days : all costs.
Medicare-covered hospital services include:
- Semi-private rooms
- General nursing
- Drugs as part of your inpatient treatment
- Other hospital services and supplies
Skilled Nursing Facilities:
Medicare Part A (Hospital Insurance) covers skilled nursing care provided in a SNF in certain conditions for a limited time (on a short-term basis). Subject to certain restrictions.
- You have Part A and have days left in your benefit period to use.
- You have a qualifying hospital stay.
- Your doctor has decided that you need daily skilled care. It must be given by, or under the supervision of, skilled nursing or therapy staff.
- You get these skilled services in a SNF that’s certified by Medicare. You need these skilled services for a medical condition that’s either:
- A hospital-related medical condition treated during your qualifying 3-day inpatient hospital stay, even if it wasn’t the reason you were admitted to the hospital.
- A condition that started while you were getting care in the SNF for a hospital-related medical condition (for example, if you develop an infection that requires IV antibiotics while you’re getting SNF care)
Your Costs? You pay:
- Days 1–20: $0 for each benefit period .
- Days 21–100: $176 coinsurance per day of each benefit period.
- Days 101 and beyond: all costs.
If you qualify for hospice care, you and your family will work with the hospice team. Together, you’ll set up a plan of care that meets your needs.
Home Health Care:
Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) cover eligible home health services like these:
- Part-time or “intermittent” skilled nursing care
- Physical therapy
- Occupational therapy
- Speech-language pathology services
- Medical social services
- Part-time or intermittent home health aide services (personal hands-on care)
- Injectable osteoporosis drugs for women
Usually, a home health care agency coordinates the services your doctor orders for you.
Medicare doesn’t pay for:
- 24-hour-a-day care at home
- Meals delivered to your home
- Homemaker services (like shopping, cleaning, and laundry), when this is the only care you need
- Custodial or personal care (like bathing, dressing, or using the bathroom), when this is the only care you need.
For more information contact a Medicare Specialist at (610) 420-6064
For Information on Part B click here