Part A Premiums
Medicare Part A is premium-free for 99% of Americans. This is because most people have paid into the system for years with employee taxes for both Medicare and Social Security. If someone has not contributed 40 quarters (10 years) or more of Medicare taxes, however, they will be required to pay premiums for Medicare as follows:
If you work 40 or more quarters, it could save you tens of thousands of dollars in Part A premiums over your lifetime. This could have a significant impact on your ability to retire comfortably.
The good news is that if you have not worked 40 quarters yourself, you may qualify for free Part A premiums based on your spouse’s employment history. This applies as long as you are married or you remain single after divorcing someone you were married to for at least 10 years.
You may be eligible to use your spouse’s record if you are widowed too. The only rule is that you remain single and were married to your spouse for at least nine months before they passed away. The rules for people who remarry can get a little tricky.
Please note that any money you earn “under the table” will not count toward your eligibility for free Part A premiums since there are no documented taxes.
Part A Deductibles, Copayments, and Inpatient Hospital Stays
Hospital costs and skilled nursing facility costs, not surprisingly, are on the rise. According to the statistics from the latest Kaiser State Health Facts survey, including data from all 50 states and the District of Columbia, each day someone was hospitalized as an inpatient in 2020 cost $2,606 in a state/local government hospital, $3,032 in a non-profit hospital, and $2,300 in a for-profit hospital.
Medicare Part A charges you a flat deductible for each inpatient hospital admission. This includes coverage for Inpatient Only surgeries.
This deductible covers all costs up to 60 days, with the exception of physician fees which are covered by Part B. After 60 days, you are charged a copayment for each additional day you are hospitalized.
In 2021, the average rate for a semi-private room in a nursing facility was $260 per day ($7,908 per month). For a private room, the cost went up to $297 per day ($9,034 per month). That’s $94,900 and $108,405 per year, respectively.
If you live in Alaska, Connecticut, Hawaii, Massachusetts, or New York, expect to pay more. These are the most expensive states for nursing home care in the country (based on the cost of a private room).
Medicare Part A covers the first 20 days of care received at a skilled nursing facility stay immediately following an inpatient hospital stay at no cost to you. Things can get tricky here because some people are placed under observation rather than admitted as an inpatient. Simply staying overnight in the hospital does not make you an inpatient.
A Word from Verywell
If you are lucky, you will never need to use Medicare Part A. You would never need hospitalization, you would never need a skilled nursing facility, and you would never need hospice care. Ultimately, though, it is important to have this coverage should you ever need it and to know how much it would cost.
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