Medicare Part A is often called hospital insurance because it pays for the care you receive while admitted as an inpatient at the hospital. It also pays some costs outside of a hospital, such as skilled nursing facility (rehabilitation) stays, home health care and hospice care.
Most Medicare beneficiaries do not owe a monthly premium for Part A, known as “premium-free Part A”, because they (or their spouse) paid into the Part A trust fund (FICA deduction from a paycheck) a minimum of 40 working quarters (about 10 years). Beneficiaries that did not work enough quarters can buy Part A, known as “premium Part A”.
Part A has a deductible of $1,556 for every benefit period in 2022. After the deductible is met for each period, Medicare generally pays 80 percent of all approved services that are covered under Part A leaving the beneficiaries to cover the remaining 20 percent. The benefit period starts at admission to the hospital and ends 60 consecutive days after your release from the hospital.
Medicare Part B is often called medical insurance because it pays for medical services such as doctor visits, preventive benefits, outpatient surgery and care, ambulance services, outpatient mental health services, durable medical equipment and home health care costs that are not covered by Part A. The Part B premium for those enrolling in 2022 is $170.10 per month. In addition to the Part B premium, there are some other out-ofpocket costs that beneficiaries can expect to pay when receiving services that are covered by their Part B. The annual deductible for Part B in 2022 is $233. Once the deductible is met, Medicare again generally pays only 80 percent of all approved services that are covered under Part B leaving the beneficiaries to cover the remaining 20 percent. Keep in mind, Medicare has strict rules on what durable medical equipment, prosthetics, orthotics, and supplies that they will cover. There are also some preventive benefits under Medicare Part B that are covered at 100 percent.
It’s important to remember that if you continue to work beyond your 65th birthday and you have employer sponsored health coverage, there may be a chance that you can delay getting Part B when first eligible. You will need to contact your employer regarding how your coverage works with Medicare.
Contact Julie or Alyssa at Roosevelt County Aging Services with any questions at 406-653-6221