AHIP Medicare - Module 1 - Overview of Medicare Program Basics: Choices, Eligibility, and Benefits - PART A

In 2023:

$1,600 deductible for each benefit period
- A benefit period begins the day an individual is admitted to a hospital or skilled nursing facility (SNF) and ends when an individual has not received hospital or SNF care for 60 days in a row.

In 2023:
Days 1-60: $) after you pay Part A deductible.

(Yes, that’s correct. Under Original Medicare in 2023, the inpatient hospital deductible is $1,600. After paying this deductible, Original Medicare covers the full cost for the first 60 days of the hospital stay13. However, after the 60th day, a copayment is required each day)

In 2023:
Days 61-90: $400 copayment per day of each benefit period

(Yes, that’s correct. Under Original Medicare in 2023, for days 61 through 90 of each benefit period, the inpatient is required to pay a copayment of $400 per day. This is after the $1,600 deductible has been met.)

In 2023:
Days 91 and beyond $800 copayment per each “lifetime reserve day” after day 90 for each benefit period.

• Lifetime reserve days are days a beneficiary may use after they have been in an inpatient hospital for 90 days. A beneficiary has 60 such days to use in their lifetime.

(Yes, that’s correct. Under Original Medicare in 2023, for days 91 and beyond of each benefit period, the inpatient is required to pay a copayment of $800 per each “lifetime reserve day”. These “lifetime reserve days” are additional days that Medicare will pay for when you’re in a hospital for more than 90 days. You have a total of 60 reserve days that can be used during your lifetime.)

In 2023:
Beyond the lifetime reserve days: all patient pays all costs.

(Yes, that’s correct. Under Original Medicare in 2023, after you’ve used all of your 60 lifetime reserve days, you are responsible for all costs. It’s also important to remember that there are other types of Medicare coverage, such as Medicare Advantage plans, that may have different cost structures and benefits.)

In 2023, beneficiaries pay the following amounts for skilled nursing and rehabilitative care covered under Original Medicare:

Days 1-20: $0 for each benefit period (as defined by Medicare).

(That’s correct. For the first 20 days of skilled nursing care, Original Medicare does not require any cost-sharing in 2023. However, for days 21 through 100 of extended care services in a benefit period, the daily coinsurance will be $200.00)

In 2023, beneficiaries pay the following amounts for skilled nursing and rehabilitative care covered under Original Medicare:

Days 21 - 100: $200 copayment per day of each benefit period.

(That’s correct. In 2023, Original Medicare requires a cost-sharing of $200 per day for days 21 through 100 of skilled nursing care. However, please note that you’re responsible for all costs beyond day 100.)

In 2023, beneficiaries pay the following amounts for skilled nursing and rehabilitative care covered under Original Medicare:

Days 101 and beyond: All Costs.

(That’s correct. In 2023, under Original Medicare, the patient is responsible for all costs for skilled nursing care for days 101 and beyond. It’s always a good idea to check with your Medicare plan for the most accurate information. Please note that some Medicare Advantage plans or other types of health insurance may cover these costs.)

1. Inpatient hospital care (including care provided by acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, and long-term care hospitals)

2. Blood

3. Up to 100 days of home health care after an individual is in a hospital or skilled nursing facility (SNF) (Note that Part B covers home health care without the prior hospital or SNF stay if Part B conditions are met.

4. Skilled nursing and rehabilitation care up to 100 days, but only after a three-day hospital stay (Medicare Advantage plans may waive the 3-day stay requirement)

5. Inpatient psychiatric care (up to 10 lifetime days).

6. Hospice care