Hospitalization Coverage

Medicare Part A inpatient care includes certain services received in a hospital, including critical access hospitals, inpatient rehabilitation facilities and long-term care hospitals.

Part A coverage includes, but is not limited to:

Semi-private room.
Meals.
General nursing.
Treatment drugs.
Other hospital services and supplies.

Clients are responsible for:

A deductible covering the first 60 days of a hospital stay.
A daily coinsurance rate for days 61-90.
A higher daily coinsurance rate for days 91–150.
All costs for day 151 and after.

Example:

Sunny is enrolled in Medicare Part A. She is hospitalized on March 17 after an accident involving a not-so-lucky leprechaun. Sunny is discharged home on July 4, just in time for Independence Day.

Action:

Sunny is responsible for the following charges:

The deductable for March 17 through May 15.

Daily coinsurance rate for May 16 – June 14.

The higher daily coinsurance rate for June 15 – July 4.

Medicare Part A cost sharing amounts can be found in the EPM Appendix C