Medicare Part A Deductible & Coinsurance Costs for 2023
Part A deductible and coinsurance costs have increased in amount from the previous year.
For 2023, the Medicare Part A deductible amount is $1,600. This amount has increased by $44 from the 2022 Part A deductible amount, which was $1,556.
Your Medicare Part A deductible applies to costs for inpatient hospital care (i.e. when you are admitted to a hospital).
Once you cover the Part A deductible amount, your Medicare coverage kicks in and begins covering costs for the first 60 days of your benefit period for Medicare-approved inpatient hospital care.
How Long Does a Part A Benefit Period Last?
Medicare uses benefit periods as a way to measure your use of covered services.
Your Part A benefit period will begin on the day that you’re admitted as either an inpatient at a hospital or skilled nursing facility.
After your benefit period has begun, it will officially end once you haven’t received any inpatient hospital care or skilled nursing facility care for 60 days in a row.
Once your benefit period ends, the next time you’re admitted to a hospital or skilled nursing facility will mark the beginning of a new benefit period.
You will once again be responsible for the Part A deductible and any potential coinsurance costs that may apply if you surpass 60 days during your stay.
We’ll cover how these coinsurance costs apply in the next section.
What Are the Medicare Part A Coinsurance Costs for 2023?
In addition to the Part A deductible, there are coinsurance costs that may apply to your inpatient hospital care, as well.
While days 1 – 60 of each benefit period are without any coinsurance costs, days 61 – 90 see a coinsurance cost of $400 per day.
This amount has increased by $11 from the 2022 amount of $389.
After 90 days, you have an additional 60 days of coverage known as lifetime reserve days. Your lifetime reserve days come with a coinsurance cost of $800 per day.
This amount has increased by $22 from the 2022 amount of $778.
Note, however, that lifetime reserve days can only be used once (i.e. they do not renew with a new benefit period).
So, if you have used up your lifetime reserve days, you’ll be responsible for all costs starting with day 91 and beyond.
For Medicare beneficiaries receiving care in a skilled nursing facility, the first 20 days of your benefit period are without any coinsurance costs.
Starting with day 21 and lasting until day 100, there is a coinsurance cost of $200 per day.
This amount has increased $4.50 from the 2022 amount of $194.50.
After day 100 (i.e. day 101 and beyond), you’ll be responsible for all costs.
How Many Medicare Lifetime Reserve Days Do I Have?
Every Medicare beneficiary receives 60 lifetime reserve days. However, it’s important to note that these reserve days can only be used once.
So, say for example that you had a Medicare-approved inpatient hospital stay that lasted 100 days, because Part A only covers the first 90 days of an inpatient stay, you have used up 10 of your lifetime reserve days during this stay.
Going forward, if you start a new benefit period with another inpatient hospital stay, you’ll only have 50 lifetime reserve days remaining were you to again exceed the first 90 days that are covered.
Once you run out of lifetime reserve days, you’ll be responsible for all costs incurred starting on day 91 and onward.
What Does Medicare Part A Cover?
If you’re enrolled in Medicare Part A, you receive coverage for inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Inpatient Hospital Care applies to people admitted to a hospital by a physician.
In this case, Part A covers certain services during your stay. The coverage extends for up to 90 days during each benefit period.
You also have an additional 60 lifetime reserve days.
For inpatient care at a psychiatric hospital, Part A covers up to 190 lifetime reserve days.
Covered Inpatient Hospital Care Services Include:
Hospital services and supplies
Also included: inpatient care you receive in acute care hospitals, critical access hospitals, rehabilitation facilities, long-term care hospitals, qualifying clinical research studies, and psychiatric hospitals.
Part A also covers the cost of care in a long-term care hospital. These are hospitals that specialize in treating patients hospitalized for 25+ days.
This might apply to a patient using a ventilator for an extended period or a patient with a severe wound or injury.
After discharge from a long-term care hospital, many patients move onto care in a Skilled Nursing Facility or custodial care in a long-term facility.
Skilled Nursing Facility Care covers a wide-range of the services offered in a Skilled Nursing Facility by a skilled nurse of therapist.
This coverage extends for up to 100 days each benefit period and also covers your room and board in the facility. It does not, however, include custodial or long-term care.
Covered Skilled Nursing Facility Services:
Hospice Care applies to those that are terminally ill.
Part A covers any necessary care used to manage symptoms and control your pain.
Part A also covers respite care and some medical equipment that is intended for use at your home.
This coverage is extended for as long as your healthcare provider determines you need the care.
Covered Hospice Care:
Any items or services needed for pain relief and symptom management
Any medical, nursing, and social services
Durable medical equipment
Aide and homemaker services
Important Hospice Care Note: Your Part A hospice care does not pay for your stay in a facility unless a short-term stay is determined necessary for pain or symptom management.
If such a stay is determined necessary, the facility must be Medicare-approved.
Home Health Care applies to those that are homebound and in need of skilled care.
Part A covers part-time skilled care in your home. For daily care, this coverage lasts for up to 100 days. For intermittent care, your coverage is unlimited.
Important Note: If you find that your circumstance does not meet the Part A qualifications for coverage, you might want to look at Medicare Part B. Part B offers additional home health care coverage.
For a complete look at the costs associated with your Medicare Part A coverage: What Are the Part A Costs for 2023?
And for a fuller understanding of your Medicare Part A costs, coverage, and more, read our Comprehensive Guide to Medicare Part A.