Is Medicare Free? It Is Far From Being Free

Here is a breakdown of the costs for just Part A

Part A, better known as Hospital Insurance; 

Covers

• Inpatient care in hospitals
• Inpatient care in a skilled nursing facility
• Hospice care services
• Inpatient care in a Religious Non medical Health Care Institution

**Coverage only starts when a beneficiary is admitted as an inpatient; it will NOT cover outpatient procedures**

Most people do not pay a monthly Part A premium due to qualifying through Social Security taxes paid throughout their or their spouse’s career. As long as the beneficiary or spouse has 40 or more quarters of Medicare-covered employment completed by age 65 then Part A will have no premiums for coverage.

For those that have not met the specific requirements by age 65 there is still an opportunity to enroll at a cost

• Those only having 30 – 39 quarters the Part A premium is $248.00 per month.
• Those that who are not eligible or have less than 30 quarters the Part A premium is $451.00 per month

There is an annual deductible of $1,156 (2012) per year.

There is a cost for an extended stay per incident past the 60th hospital stay

• Days 61 – 90 will costs a beneficiary $289 per day
• Days 90 – 150 will costs a beneficiary $578 per day
• After Day 150 the beneficiary will incur all of the costs

 Skilled Nursing; After a 3 day inpatient stay along with a prescription by the attending doctor the costs are;

• For the first 20 days – $0
• For days 21 through 100 the cost is $141.50 for each benefit period.
• After day 100 all costs are the full responsibility of the beneficiary

Medicare will only cover the care a beneficiary gets in a SNF if they first have a “qualifying hospital stay”.

Home Health Care;

The only cost is a 20% co pay for most Medicare-approved durable equipment after the Medicare Part B deductible for the year has been met.

Hospice Care;

• A copayment of up to $5 per prescription for covered outpatient prescription drugs for symptom control or pain relief
• 5% co-pay of the Medicare-approved amount for inpatient respite care (short-term care given by another caregiver so the usual caregiver can rest)
• All costs for room and board for hospice care in your home or another facility where you live (like a nursing home).

Blood;

If the beneficiary is an inpatient, needs blood, and the hospital has to buy the blood, each calendar year they would pay for the first 3 pints (the deductible) and 20% for any additional pints, unless you or someone else donates blood to replace what you use.

In most cases, the hospital gets blood from a blood bank at no charge and you won’t have to pay for it or replace it.

Still think Medicare is Free????

Part A is the one part that everyone gets automatically at age 65 and the word cost(s) appears 4 times alone.