What Are the Medicare Part A Costs for 2021?
Learn the scenarios in which Part A costs apply.
If you’re a Medicare Part A beneficiary, you may be interested in learning what costs are associated with your coverage for 2021.
Part A costs have increased in amount from the previous year, so you may find it helpful to know the new amounts and understand when these costs apply to your healthcare.
As an Original Medicare beneficiary (Parts A and B), you can think of your Part A coverage as your hospital insurance. It helps to cover costs for inpatient hospital care, skilled nursing facility care, home health care, and hospice care.
The costs for Medicare Part A coverage can come in the follow three forms:
Part A Deductible
Part A Coinsurance
Part A Premium
Below, we’ll cover the scenarios in which these costs apply to Medicare Part A beneficiaries. We’ll also provide you with the current 2021 amounts for the Part A deductible, coinsurance costs, and premium.
What Is the Medicare Part A Deductible Cost for 2021?
For 2021, the Medicare Part A deductible amount is $1,484. The Part A deductible applies to your healthcare costs for inpatient hospital care (i.e. when you’re admitted to a hospital).
Once you cover the Part A deductible amount (i.e. have paid $1,484 toward Part A services), 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 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 an inpatient at either 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.
What Are the Medicare Part A Coinsurance Costs for 2021?
During your inpatient stay, days 1 – 60 of each benefit period are without any coinsurance costs. The costs for this span of days are covered once you have met the Part A deductible mentioned in the previous section.
Starting with day 61, however, there are coinsurance costs that will apply to your Part A coverage. The 2021 coinsurance costs have increased in amount from the previous year.
Days 61 – 90 come with a coinsurance cost of $371 per day for 2021.
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 $742 per day for 2021.
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 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 $185.50 per day for 2021. After day 100 (i.e. day 101 and beyond), you will be responsible for all costs.
How Many Lifetime Reserve Days Do I Have?
Every Medicare beneficiary receives 60 lifetime reserve days, which can only be used once. So, if you use up these 60 lifetime reserve days during one or multiple inpatient stays, they do not replenish with a new benefit period.
Once you run out of lifetime reserve days, you’ll be responsible for all costs incurred starting on day 91 and onward.
Breakdown of Medicare Part A Costs by Coverage Type
As mentioned above, Medicare Part A covers the following types of healthcare coverage: inpatient hospital care, skilled nursing facility care, home health care, and hospice care. Here, we’ll show you how costs apply specifically to those coverage types.
Inpatient Hospital Care Costs
For both hospital inpatient stays and mental health inpatient stays the following costs are associated with your stay for each benefit period:
$1,484 deductible.
Days 1 – 60: $0 coinsurance per day.
Days 61 – 90: $371 coinsurance per day.
Days 91 and beyond: $742 coinsurance per day while lifetime reserve days last (60 days). After lifetime reserve days are used up, you’re responsible for all costs.
Additionally, note that the following costs can apply:
During your hospital inpatient stay, you’ll be responsible for the cost of a private room (unless deemed medically necessary), private-duty nursing, and amenities such as a television or phone in your room.
During your mental health inpatient stay, you’re responsible for 20% of the cost for any Medicare-approved mental health service you receive from a doctor or other provider.
While there is no limit to the number of benefit periods you can have when receiving mental health care in a general hospital or psychiatric hospital, there is a lifetime limit of 190 days.
Skilled Nursing Facility Care Costs
For skilled nursing facility stays the following costs are associated with your stay for each benefit period:
No deductible.
Days 1 – 20: $0 coinsurance per day.
Days 21 – 100: $185.50 coinsurance per day.
Days 101 and beyond: You are responsible for all costs.
Home Health Care Costs
For home health care the following costs are associated with your care for each benefit period:
No deductible.
No coinsurance costs.
You must cover 20% of the cost for any Medicare-approved durable medical equipment (DME).
Hospice Care Costs
For hospice care the following costs are associated with your care for each benefit period:
No deductible.
No coinsurance costs.
Additionally, note that the following costs can apply:
While at home, if you require prescription drugs or similar products for pain relief and symptom control, you may be required to pay a copayment of no more than $5 for each prescription.
You may be required to pay 5% of the Medicare-approved amount for inpatient respite care.
Keep in mind that Medicare does not cover room and board costs if you receive hospice care in your home or a facility in which you live, such as a nursing home.
What Is the Medicare Part A Premium Cost for 2021
What’s most important to establish with the Medicare Part A premium is that it doesn’t apply to all Part A beneficiaries.
In fact, the Part A premium does not apply to a vast majority of Medicare beneficiaries. Rather, most Medicare beneficiaries qualify for premium-free Part A coverage, in which there is no monthly premium required for coverage.
This premium-free Part A coverage does apply to most beneficiaries, but if you would like to check whether or not you qualify for premium-free Part A, consult our guide here.
For those that do not qualify for premium-free Part A, however, you’ll be required to pay a monthly premium for your Part A coverage. The exact amount you must pay will depend on two factors:
The number of quarters you have paid FICA tax.
When you purchase your Part A coverage.
Number of Quarters You Have Paid FICA Tax
For individuals that have not paid the full 40 quarters of FICA taxes, you will have to pay a monthly premium for your Part A coverage.
For those that have only paid Medicare taxes for 30 – 39 quarters (i.e. between 7.5 and 9.75 years), the standard Part A monthly premium is $259.
And for those individuals purchasing Medicare Part A that have paid Medicare taxes for less than 30 quarters (i.e. 7.5 years), the standard Part A monthly premium is $471.
When You Purchase Your Part A Coverage
The period in which you’re first eligible to enroll in Medicare is known as your Initial Enrollment Period. This period begins 3 months prior to your 65th birthday month, includes your birthday month, then extends for an additional 3 months after.
If you wait until this period is over to enroll in Part A, you may be subject to a late penalty that would increase your standard monthly premium amount by 10%. How long you end up having to pay this late penalty will depend on how long you waited to enroll.
The higher premium amount due to late penalty will be applied for twice the amount of years that you did not sign up for Part A once eligible.
To learn more about the Part A Late Enrollment Penalty and view examples of how it is applied, read our article on the Part A Late Enrollment Penalty.
Helpful Resource:
Medicare: Medicare Costs at a Glance
