May 3, 2011
Medicare Part A Hospital Insurance in 2011
Hospital Insurance Premiums for 2011
If you or your spouse has paid more than 40 quarters of Medicare-covered employment, you should not have to pay a premium for Medicare Part A hospital insurance.
If you worked 30 to 39 qualified quarters, your Medicare Part A premium for hospital insurance would be $248 per month in 2011.
If you worked fewer than 30 qualified quarters, the monthly Medicare Part A premium in 2011 is $450.
If you return to work and are no longer eligible for premium-free Medicare Part A hospital insurance, you can still buy Medicare hospital insurance for $450 per month. Keep in mind, however, that if you choose to buy Medicare Part A under this circumstance, you must also have Medicare Part B medical insurance and pay that premium as well. If you're under 65 and disabled, you can keep your premium-free Medicare hospital insurance for up to eight and a half years after you return to work.
Also, even if you aren't eligible for premium-free Medicare Part A, you still have to get it when you first become eligible. The penalty for late enrollment is 10% of the premium cost. You continue to pay that penalty two years for each delayed year. For example, if you delayed enrollment by two years, you would pay the penalty for four years. There are exceptions that allow you to delay enrollment without a penalty. For example, if you have other creditable hospital insurance, you may, without a penalty, delay signing up for Medicare Part A. Once that other coverage ends, you should enroll in Medicare Part A right away.
Be sure to consider these monthly payments when calculating your retirement income needs. Medicare premiums are usually deducted from your Social Security retirement checks, so there is no bill to pay. Your retirement income will be reduced by the premium amount.
Medicare Part A Dedutible
A deductible is the amount you pay first before your insurance begins to pay for your health care expenses. Some Medicare Part A covered services do not carry a deductible. Those include home health care, hospice care and a stay in a skilled nursing facility.
You do pay a deductible when you are a patient in a hospital (called inpatient care). Inpatient care refers to when a doctor formally admits you to the hospital. It does not include an overnight stay in an emergency room. That would be covered under your medical insurance. The Medicare Part A deductible for an inpatient stay is $1,132 for the first 60 days. If you are in the hospital longer than 60 days, you will begin paying copayments.
Medicare Part A Coinsurance
Coinsurance is the amount you contribute to the total cost of the service. This can be a flat amount or a percentage of the total bill. The Medicare Part A hospital insurance covers the rest.
There is no coinsurance for home health care. However, you will pay 20% of the approved Medicare amount for durable medical equipment such as a wheel chair or oxygen tank.
You pay nothing out of pocket for long-term hospice care. However, if your normal in-home caregiver needs a break, you can receive short-term respite care and pay five percent of the Medicare approved amount. You also pay up to $5 for each prescription drug given for symptom management as an outpatient.
The Medicare Part A deductible covers the first 60 days of your inpatient hospital stay. After that, your Medicare Part A copayment for inpatient hospital care is $283 per day for days 61 through 90 of your stay. After day 90, you pay $566 per day for 60 days (days 90 through 150) over your lifetime. The copayment days begin anew each benefit period. If you have reached your lifetime maximum, you pay the full amount.
For a stay in a skilled nursing facility, you pay nothing for the first 20 days. After that, you pay $141.50 per day up to 100 days and the full amount thereafter.
