Medicare Part A is known as hospital insurance. Most people with Medicare pay no premium for this coverage. It is funded by payroll taxes when you were working.
There are no Medicare hospital networks but most enrollees will have a deductible. In 2021, the Part A hospital deductible is $1,484 for each benefit period through day 60, at which time they pay co-insurance of as much as $742 for every day they’re in the hospital.
A person’s Medicare hospital benefit period starts the day they are admitted to the hospital or skilled nursing rehab facility. It ends when they enrollee has been out of those facilities for 60 consecutive days.
After that time, the Part A hospital benefit period re-starts and the enrollee will pay another deductible if they have another hospital stay.
Here is an example of how the benefit period works.
You are ill and admitted to the hospital for two nights. You will pay the first $1,484 of fees out of your own pocket. If your hospital bill is more than this amount, Medicare will pay it for you.
In this scenario, the hospital sends you home and you become ill one month later and are re-admitted to the hospital. There is no deductible because it has not been 60 days since your first stay. You are still in the same benefit period and Medicare will pay your hospital bill.
Now imagine you fall and break your hip three months later. You are in a new hospital benefit period because you've been out of the hospital for more than 60 days. If you are admitted, you will once again pay the first $1,484 of your hospital bill and Medicare will pay the rest.
People with a Medicare supplement insurance policy will pay a different amount. All but one kind of Medigap plan pays at least some of a person's hospital deductible. Plans B, C, D, F, G and N cover it entirely.
Medicare Advantage plan enrollees get their Medicare benefits from a private insurance company. In most cases, their plan charges a copay for each night they're in the hospital (typically around $250) up to a plan limit, at which time the plan will pay everything.
Medicare Advantage plans typically have lower hospital cost-sharing. This is because unlike Original Medicare, these private plans have a hospital network that must be used.
If you receive non-emergency care from a hospital that isn't in the Advantage plan's network, you may be responsible for paying the entire bill out of your own pocket.