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NC Medicare Part A

How Much Does Part A Cost?

Most people qualify for NC Medicare Part A at no cost.  If either you or your spouse have paid Medicare taxes through employment for 40 quarters or more you qualify for free Part A coverage.  If you do not qualify for free Part A coverage then the monthly premium for 2016 is $411 per month. 

 

What is Medicare Part A?

Part A is referred to as Hospital Insurance and covers the following:

  • Inpatient Hospital care
  • Inpatient care at a skilled nursing facility
  • Hospice care services
  • Home health care services
  • Inpatient care at a Religious Non-medical Health Care Institution

 

What Costs am I Responsible for Under NC Medicare Part A?

Let's look at each one of the above individually:

  • Inpatient Hospital Care
    • Medicare covers semi-private rooms, general nursing, meals, and drugs while you are under inpatient hospital care (note that Part A does not cover the doctor services, this is covered under Part B).
    • In 2016 you pay a deductible of $1,288 for days 1-60 of each benefit period.  Note this is not an annual deductible, but by benefit period.
    • Days 61-90 you pay $322/day
    • Days 91-150 you pay $644/day (known as your "lifetime reserve days")
    • You pay all costs after day 150
    • You are limited to 190 days lifetime for an inpatient stay in a psychiatric hospital for mental health care
  • Inpatient Care at a Skilled Nursing Facility
    • You pay $0 per day 1-20 of each benefit period
    • You pay $161 per day for days 21-100 of each benefit period
    • After day 100 you pay all costs in a benefit period
  • Hospice Care Services
    • You pay $0 for hospice care
    • You pay up to $5 per prescription drug that is administered for pain and symptom management
    • You pay 5% of the Medicare approved amount for inpatient respite care.
  • Home Health Services
    • You pay $0 for covered home health services (physical therapy, speech-language pathology services, etc)
    • You pay 20% of the Medicare approved amount for durable medical equipment
  • Religious Nonmedical Health Care Institution(Inpatient care)
    • Medicare will only cover the non-medical/non religious health care services like room and board in this type of facility.

As you can see from above, NC Medicare Part A covers a lot of major ticket items.  However, having Part A and Part B (Original Medicare) alone will leave you exposed to some serious medical bills which could lead to financial ruin....you don't want to jeopardize your golden years!  This is why it is important to cover the gaps (the items above that you are responsible for) of original Medicare with either a NC Medicare Advantage plan or a NC Medicare Supplement.