Medicare Benefit Periods - Learn How They May Affect You!

A benefit period is how the Original Medicare program measures your use of inpatient hospital and also your skilled nursing facility services. A Medicare benefit period begins the day that you enter a hospital or skilled nursing facility and then ends when you have not received inpatient hospital or Medicare covered skilled care in a skilled nursing facility for 60 days in a row. Please note that the benefit period is not tied to the calendar year. 

If you go back into the hospital or a skilled nursing facility after one benefit period has ended (more than 60 days after you left), a new benefit period begins. There is no limit to the number of benefit periods you can have, or how long a benefit period can be.  

Benefit periods also affect how much you may pay for your inpatient hospital or skilled nursing facility stay. You must meet your Part A deductible at the beginning of each benefit period as well as pay a daily coinsurance depending on how many days you stay at the hospital or skilled nursing facility during one benefit period.  

After you meet your Part A deductible at the beginning of the benefit period, the first 60 days of your inpatient hospital stay are covered with no daily coinsurance. Likewise, if you qualify for a Medicare-covered skilled nursing facility stay, you will pay nothing for the first 20 days of your skilled nursing facility stay within a benefit period.  

In 2016, Original Medicare Part A costs for hospital and skilled nursing facility stays are:

  • Deductible: $1,288 for each benefit period
  • Hospital coinsurance: $0 for the first 60 days of inpatient care each benefit period; $322 per day for days 61-90
  • Skilled nursing facility coinsurance: $0 for the first 20 days of inpatient care each benefit period; $161 per day for days 21-100  

Click on web link below to read related article:

Medicare Part A, Benefit Periods, and Deductibles

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