What is Medicare Part A and how to avoid multiple $1,556 deductibles per year? 

Make sense of the different Medicare products, co-insurance, and deductibles to help you find the best healthcare choices. 

Do you feel like you’re still struggling to reduce your deductibles?

You’re not alone. To add to the confusion, a lot of people don’t realize that you can be charged multiple times for the $1,556 deductible if they go to the hospital numerous times.

How?

60 days after you’ve been discharged from the hospital, a new benefit period starts. If the patient goes back into the hospital, they’ll be on the hook for another $1,556 deductible if it’s within the same calendar year.

Recently, income-related monthly adjustments have been announced. Understanding Medicare Part A and associated deductibles might be giving you a headache. If so, this article will help. In this post, we will talk about deductibles, the origin, and advantage of Medicare, final cost, and avoiding casual deductibles or penalties. 

As we always advise at STL Medicare Benefits, the essential thing to consider before choosing any healthcare option is to ensure you have transparency about your plan coverage and pricing. Partnering with top-rated health insurance companies that educate their clients is a plus too.

Wondering what your Medicare savings are? Ask STL Medicare Benefits to find out for you! Ask about any Medicare product; your dedicated advisor will guide you as we have with many of our clients before.

Basics of Medicare Part A

Now, coming back to where we have left our initial discussion. Sometimes we face some unexpected events throughout the year. It can be a car accident or an uninvited ailment. You don’t want to spend a lifetime’s worth of savings on just one unfortunate incident. These are the very reasons to be looking at the right kind of health insurance plan before you find out that you’re underinsured or don’t have the best plan for your financial situation. Medicare is a basic program further divided into four sub-programs, however, we will keep our focus on Medicare Part A. 

Before digging into facts and figures, let’s understand what this product is and how one can utilize this program in the future. The program consists of bite-sized chunks of coverage, including all the hospital-related coverage. It further covers inpatient hospital stays, home healthcare, and skilled nursing facility care. 

Tip:  Your monthly Medicare premium is not applicable if you have paid 10 years’ worth of Medicare taxes.

How to enroll for Medicare Part A?

Your health matters; don’t miss out on details of the enrollment plan updated every year. Each year, medicare.gov introduces a Medicare service with a specific schedule, changing the costs, deductibles, and coverages. STL Medicare Benefits works as the Medicare finder who doesn’t just educate but helps clients get enrolled with the suitable plan that suits their healthcare needs. 

We stay persistent in finding the healthcare providers, partner with them, discuss your investment limitations, and help you enroll. Need help with Medicare products or need to sign up for both Part A and B? We’re here to keep you aware of all the information to strengthen your healthy life. No need to undertake the stress or waste time searching – we hear and provide solutions according to our client’s healthcare needs. Book a meeting with us to find the best healthcare partners for your future – we take care of your Medicare coverage so you can relax.

Call us for more details: (314) 203-9246.

Example of how Medicare Part A works

For a quick understanding of how Medicare Part A, imagine this scenario. In the unfortunate event that someone has heartache and goes to the ICU, the patient will have a $1,556 deductible. From day 1 to 60, 100% of the hospital expenses will be covered.

Beyond day 60-90, the costs are $389/day and beyond day 91*, the daily rate increases to $778/day.

*Note: any day about 91 days in the hospital is considered to be lifetime reserve days. You only get 60 days and they can only be used once.

Deductible – $1556

Days 1-60 – $0

Days 60-90 – $11,670

Total for 90 days in the hospital = $13,226

What to know about Medicare Part A coverages? 

Medicare coverage is based on three major factors – state and federal laws, national coverage decisions, and local coverage decisions determined by the direction of the companies in the specific state. Medicare.gov introduced and updated the cost and coverages of these products in Nov 2021. Now that we have the list of coverages in hand, let’s understand what’s needed to manage the right plan for you.

What is covered? 

Following are the components that are part of this product. Do you want to explore how they work? Keep reading for a simple explanation… 

Hospital Insurance 

The eligible age for this program is 65+ years old. Once you qualify for this plan, you can buy Part A. In Medicare Part A, a beneficiary pays $499 each month in 2022. The standard Medicare Part A premium will remain the same ($499) if you or your partner have paid less than 30 quarters. However, if the taxes are paid for more than 30 quarters, the amount can fall to $274 per month. 

Inpatient Hospital Care

A person is considered to be an inpatient when they’ve been admitted after their doctor’s official recommendation. Medicare Part A ensures you have the best coverage by covering services like semi-private rooms, meals, general nursing, drugs, and other hospital services. Usually, the period of inpatient care extends to 190 days. 

Skilled Nursing Facility Care 

Medicare Part A gives coverage for skilled nursing facility care. Commonly, a beneficiary can elect for service when they have Part A and is left with days in their benefit period. Other than that, a beneficiary must be a qualifying inpatient of the recommended hospital.

So, what is skilled nursing, and how is it executed in the hospitals? Generally, skilled personnel performs therapies and nursing to give patients more attention than the usual patients in the hospital. It includes special care and evaluation of the patient’s condition. 

Hospice Care

Are you familiar with hospice care? It is a specific care service for those whose illness or condition is incurable and towards the end of their life. This care focuses on the care, quality, and comfort of the patient who struggles and depends on someone.

When is it applicable? Firstly, when your doctor mentions the life expectancy period of six months. Secondly, a patient prepares to get comfort care instead of expecting illness care that can’t be cured. Last but not the least, while signing for hospice care, the patient must be aware that they won’t be able to claim other medicare services for the terminal illness. Patients usually don’t pay for this service, but they have to pay $5 for the prescriptions mentioned and are not added to the Medicare program. 

Home Healthcare Service 

Both Part A and Part B cover home healthcare services in the following conditions:

• Physical therapy
• Part-time skilled nursing care
• Speech-language therapy
• Occupational therapy
• Medical social service 
• Injectable drugs for women
• Durable medical equipment
• Medical supplies for home

Part A cost and deductibles to remember in 2022

Coverages	Coinsurance	Deductibles	Penalties
Part A Premium	_	$499 each month (If paid less than 30 quarters)  $0 each month (when paid more than 40 quarters) $1,556	The monthly premium includes 10% extra on late enrollment
Hospital Inpatient Service	Days (1-60): $0 Days (60-90): $389 per day Days (91 and above): $778 per lifetime reserve day		_
Hospice care	$0 for hospice care and $5 for drugs or specific prescriptions. $5 for respite care	_	_
Home Health Care	$0 for home healthcare  20% for DME (Durable Medical Equipment)	_	_
Skilled Nursing Facility Care	Days (1-20): $0 Days (20-100): $194.50 per day Days (101 and above): All cost	_	_

When can one get eligible to apply for Premium-Free Part A?

As the condition applies, most people who are regularly working pay their taxes during employment. The good news? It helps and counts towards your Medicare costs as you get rid of paying the deductibles for Part A Medicare.

As mentioned earlier, this is the premium-free plan for Part A Medicare.

Do you want to find out if you’re eligible for this product?

Here are the specific conditions to remember at the age of 65: 

• When you’re already getting retirement benefits from Social Security or Railroad Retirement Board. 
• Eligible to claim the Social Security or Railroad Board benefits but didn’t get a chance to file them. 
• You or your partner had MGE (Medicare-covered Government Employment) 

Furthermore, you can claim Premium-Free Medicare Part A under 65 when:

• Having disability benefits from Social Security or Railroad Retirement Board for 24 months. 
• When you’re fighting with End-Stage Renal Disease and meeting specific requirements. 

Closure

We have discussed plenty of things about Medicare Part A and hope you take away a better understanding of the benefits and what to look out for in the future. STL Medicare Benefits intend and wish to educate clients by navigating them to better plans. It’s a confusing topic to navigate alone and doesn’t require you to put in a lot of extra effort. Medicare programs, including Medicare Part A, are easy to get once you are enrolled and understand the déductibles as well as total costs. A life without the right health coverage shouldn’t be a concern you have to worry about. Therefore, get yourself registered with the right Medicare programs if you are eligible by discussing with STL Medicare Benefits. We find you the best options in the market.

Want to discuss more? Share your thoughts with us by scheduling a call or filling out our form.  

Frequently Asked Questions