Medicare Part A Services
Hospital Stay
What is Semi-private room, meals, general nursing, other hospital services, and supplies. This includes care in critical access hospitals (CAH). This does not include private duty nursing or a TV or telephone in the room. It also does not include a private room, unless medically necessary.
Inpatient mental healthcare is an independent psychiatric facility is limited to 190 days in a life time
Hospital Stay days
What is days 1-60 Part A current year inpatient deductible
Days 61-90 Part A coinsurance (1/4 or 25% of current year deductible)
Days 91-150 Part A lifetime reserve (LTR, 1/2 or 50% of current year inpatient deductible)
Hospital Stays:
Days 1-60
Days 61-90
Days 91-150
What is:
$1316 per spell of illness (1-60)
$329 per day (61-90)
$658 per day (91-150)
SNF Care
What is semi-private room, meals, skilled nursing and rehabilitative services, and other services and supplies (after a three-day hospital stay)
SNF Care
What is days 1-20: no deductible or coinsurance
Days 21-100: 1/8 of current year inpatient deductible
SNF Care
Days 1-20
21-100
What is:
$0 per benefit period (1-20)
$164.50 per day (21-100)
Home health care
What is part time skilled nursing, PT, OT, ST, HH aide services, DME and supplies and other services
Home health care
HH: no deductible or coinsurance
DME: coinsurance (20% of Medicare-approved amount)
Home Health Care & DME
What is:
Home Health- $0
DME Depends on the value of DME
Hospice Care
What is medical and support services; drugs for symptom control and pain relief; short-term respite care; care in a hospice facility, hospital, or nursing home, when necessary; and other services not otherwise covered by Medicare. Home Care is also covered.
**this does not include room and board when hospice care is provided in a the home or another facility in which the patient lives, such as a nursing home
Hospice care
What is:
Hospice care: none
Outpatient prescription drugs: current year prescription co-payment
Inpatient respire care: current year respite care coinsurance
Hospice Care, OP prescription drugs & IP respite care
What is:
HC: $0
Prescription:up to $5.00 per script
Respite Care: 5% of Medicare-approved amount
Blood
What is blood received at a hospital or SNF during a covered stay
Blood
What is Current blood deductible (unless the patient or someone else donates to replace the blood received)
Blood cost
What is:
First 3 pints per year