ber of 60-day periods. As each period begins, the patient’s doctor must recertify that the patient is terminally ill. A period begins the first day that care is given and ends when either the 90 or 60 days are up. As long as the physician certifies that the patient is terminally ill, that person can continue to receive care uninterrupted.
I keep saying that Medicare will help pay for covered expense if you meet certain conditions. Medicare has different criteria that patients must meet before they can receive benefits. For example, if you were to enter a skilled nursing facility, in order for your stay to be covered, you must first have been in the hospital for at least 3 days, you must stay in a Medicare-certified facility, and you must enter within 30 days of your hospitalization. For home health care costs to be covered, you must be homebound and have been in the hospital for at least 3 days in the 14 days prior to receiving benefits. There are other requirements, but that’s just a taste. (See Table 13.3.4)
Table 13.3 Medicare Part A
What Medicare covers Inpatient hospital care
What you pay*
deductible of $792 per benefit period
(up to 90 days per stay plus 60 lifetime reserve days)
Skilled nursing facility (up to 100 days)
no copayment for days 1–60
$198/day copayment for days 61–90 $396/day copayment for reserve days no deductibles
Home health care Hospice care
no copayment for days 1–20 $99/day copayment for days 21–100 no deductibles or copayments
no deductibles small copayment for outpatient drugs and inpatient respite care
*There is no premium in most cases for Part A.
4Copayment and deductible amounts are as of 2001.