MEDICARE (PART A): ENROLLMENT, COST & COVERAGE
What is Medicare Part A?
Medicare Part A primarily covers inpatient hospital care. This type of care typically involves the patient being admitted to a hospital for treatment and provided with lodging and food for the duration of their stay. In contrast, outpatient hospital care refers to situations where the patient receives medical services at a hospital but returns home instead of requiring lodging.
You can think of inpatient hospital care as staying overnight at the hospital.
Cost of Medicare Part A
About 99% of Medicare beneficiaries have no monthly premium. For these individuals, they incur no monthly charges for this part of Medicare.
Enrollment
There are three times you can enroll for Medicare:
1. Initial Enrollment - The initial enrollment period begins 3 months before you turn 65 and last until 3 months after you turn 65 (for a total of 7 months). For those eligible, enrolling in Medicare Part A during this period is typically advantageous, as the premium for most participants is generally zero.
2. Special Enrollment - If you miss the Initial Enrollment period, there are opportunities to apply during Special Enrollment periods. There are a wide variety of Special Enrollment situations, which can be found here, but the most common by far is if you had a job that provided you health insurance coverage.
In this situation, you can enroll in Medicare Part A anytime from when your Initial Enrollment period ends, or up to 8 months after your employment or coverage ends, whichever comes first.
3. General Enrollment - You can sign up between January 1-March 31 each year. This is called the General Enrollment Period. Your coverage starts the month after you sign up. You might pay a monthly late enrollment penalty, if you don’t qualify for a Special Enrollment Period.
Coverage & out of pocket costs
The out-of-pocket costs for Medicare Part A can be intricate, but they primarily consist of two types: the deductible and coinsurance.
Deductible: For the year 2024, the deductible is set at $1,632 for each benefit period.
Coinsurance: This varies based on several elements, such as the daily expense of the hospital stay, the length of time spent in the hospital, and the utilization of lifetime reserve days.
Calculator
The calculator below can be used to estimate your out of pocket costs for a medical event under Medicare Part A.
Explore the Medicare Part A Out-of-Pocket Cost Calculator to understand potential expenses for hospital stays and skilled nursing facility fees under Medicare Part A. This tool offers estimates based on current Medicare rates and coverage guidelines.
The calculators on the site provide a high level overview of your financial picture. For comprehensive planning, schedule a meeting.
