Medicare Part A: What is a Benefit Period?

hospital stay medicare part aOften times you will hear the term Medicare Benefit Period. Do you know what it means?

The services you receive as an inpatient in a hospital or skilled nursing facility (SNF) is considered a “benefit period” under Medicare Part A.

The benefit period begins the day you are admitted to the hospital as an inpatient and ends when you have not had any inpatient or SNF care for 60 days in a row.

On day 61 a new “benefit period” begins.

Although you can have more than one hospital stay during a benefit period, there is a limit on how many days Medicare will cover you during a benefit period.

There is no limit on the number of benefit periods you can have over your lifetime.

What are my Hospital Costs during a Benefit Period?

  • $1,288 deductible (2016) for each benefit period.
  • Days 1–60: $0 coinsurance for each benefit period.
  • Days 61–90: $322 coinsurance per day of each benefit period.
  • Days 91 and beyond: $644 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime).
  • Beyond lifetime reserve days: all costs.

If you are admitted as an inpatient, Medicare Part A helps cover hospital services. Here are some of the services generally included:

  • A semi-private room
  • Breakfast, lunch and dinner (meals)
  • Nursing care
  • Inpatient drugs as part of your treatment
  • Any other hospital services and supplies

Your Part A coverage doesn’t include doctors’ services. Part B helps cover some of the doctors’ services you get when you’re a hospital inpatient.

What is your Medicare Part A hospital Status, inpatient or outpatient?

The various co-payments and hospital charges you might have for any services and supplies really depends whether you are classified as an inpatient or outpatient. Just because you stay in the hospital overnight doesn’t mean you are an inpatient.

Not sure, ask your doctor or hospital staff.

Knowing your hospital status is an important subject and we will write more about this. But in the meantime, if you are in the hospital ask what your status is, this is really important.

For more information, visit http://Medicare.gov/what-medicare-covers/part-a/inpatient-or-outpatient.html

You can also call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Have questions? Please feel free to leave us a comment or send us an email at medicaretipsforseniors@gmail.com. We will be happy to see what we can do to help you understand the Medicare system a little better.

Thank you!

 

 

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s