Part A Inpatient Hospital deductible $1,676 but if I have Part C Advantage Plan, the hospital $350 copay per day 1-7 so how does this work?
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The Part A (IN-patient hospital) copay per day will vary among Advantage plan companies. However, the $1,676.00 has been determined by Medicare itself every new year. Since that figure is the maximum that you'll pay for that one specific hospital visit, the daily rate will be applied toward that amount. Thus, if you're in the hospital for the typical 3 days, $1,050.00 ($350.00 times 3) will be applied toward the $1,676.00. That means that you have yet to arrive at the annual deductible in that example. Since Medicare keeps track of your Inpatient hospital stays, there will be the leftover amount of $626.00 that will remain as your responsibility should you be officially admitted to a hospital within that same calendar year.
Without a Part C Advantage plan, you are responsible for the $1676 Medicare deductible. With a Part C Advantage plan, your share is $350/day for days 1-7, not $1676/day for days 1-7. I am here to help, Bill Lawler
Generally with Medicare Advantage coverage it's a set copay per day with no deductible for Medicare approved Inpatient Hospital care. Please see your Evidence Of Coverage for specifics or contact your Broker.
Plans are insured or covered by a Medicare Advantage (HMO, PPO and PFFS) organization with a Medicare contract and/or a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Original Medicare is a 20% out of pocket for all services.
A Medicare Advantage or Part C plan has an inpatient hospital deductible of $x per day for 1-6 days typically. That is your responsibility with your Medicare Advantage plan.
To summarize:
You would not pay both of these charges. If you have Part A only would you pay the $1676 deductible (or 20%) and with the Medicare Advantage Part C plan you would pay the $350 per days 1-5 deductible and after that, you would not have any additional inpatient hospital charges.
Part C supersedes Original Medicare so you would only pay the daily co pay. While a full seven days would cost more ($2450)than the $1676, the trade off is when you’re only in for 1-5 days it’s considerably less.
Your out-of-pocket will only be any days 1 thru 7 that you are an inpatient at a hospital. You will be responsible for however many days times $350. It is strongly suggested to purchase a separate Hospital Indemnity Plan to cover those days and daily rates in the event you are in the hospital as a patient. After day 7, your plan will cover the costs. But also realize that the average stay in a hospital is about 5 days. Get the HIP - they're low cost and you'll be glad to get reimbursed when you have hospital stays.
When you're on a Part C, it does not follow the Medicare Part A deductible at all. You signed a contract with that Medicare Advantage plan to pay the co-pays outlined in the Summary of Benefits and Evidence of Coverage for your plan. In this example, you would pay a maximum of $2,450 for your hospital stay if you stayed for 7 days. Take the $350/day and multiply that by the number of days. The average hospital stay length is two days, in which case you'd only pay $700. If you had a two day stay on original government Medicare, you'd pay the $1,676 for that two day stay. So you make out better with your plan for a shorter stay.
The Medicare benefits included in your selected Medicare Advantage (Part C) replaces the Medicare Part A benefits. Thus, you would not be charged the $1676 deductible, and your cost sharing would be covered at $350 copay per day 1-7.
The copay in a Medicare Advantage plan eliminates the Part A deductible. These plans are subsidized by the Federal Government and CMS (Centers for Medicare & Medicaid) and are designed to lower out of pocket costs in comparison to Original Medicare Part A & B.
The Part A deductible is due to the hospital on the first day of your inpatient visit. However, Medicare Advantage Plans (Part C) are designed to ease that burden on the member. Instead of one large deductible, these plans often charge a daily copayment based on the number of days you're hospitalized.
For example, if you're admitted for only 2 days, you might pay around $700 total instead of the full $1,676 Part A deductible.
That’s why it’s so important to compare plan benefits—not just the brand name. You may have had a great experience with XYZ Insurance while working, but once enrolled in their Medicare Advantage plan, the copayments and hospital costs could be much less favorable.
Shop by coverage, benefits, and star ratings—not by brand loyalty.
With a Medicare Advantage (Part C) plan, you generally don't pay the Medicare Part A deductible ($1,676). Instead, you'll be responsible for the copay outlined in your specific Part C plan. For example, if your plan has a $350 copay per day for the first 7 days of an inpatient hospital stay, that's what you'll pay. Your Advantage plan replaces Original Medicare's Part A benefits, so you'll follow your plan's cost-sharing rules, not those of Original Medicare.
Medicare Part C your out-of-pocket costs for inpatient hospital care are different from Original Medicare Part A. Part A has a deductible of $1,676 for each benefit period. Advantage Plans usually have a copay of $300-350 per day for the first 5-7 days, and then a different cost for additional days, which could be zero The exact cost-sharing for MA plans vary by plan. Make sure to check your plan's specific coverage and cost information.
Your Part C plan with a private insurance company replaces your Government Part A and B Benefits - and also includes a Part D Rx plan. Accordingly, your Medicare Benefits are now defined by the Part C plan and must be equal to or superior to the Original Medicare Part A and B benetits - therefor you would be subject to the $350/day for days 1-7 for each hospital admission.
With a Medicare Advantage (Part C) plan, you generally don't pay the Part A deductible ($1,676). Instead, you'll pay the copay amount specified by your plan for hospital stays. In this case, your plan has a $350 copay per day for the first 7 days of a hospital stay. This means you'll pay $350 each day for the first 7 days, and then your plan will cover further costs according to its specific rules.
Here's a breakdown:
Original Medicare (Part A):
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You'd first pay the $1,676 deductible, and then Medicare pays for the first 60 days of a hospital stay. For days 61-90, you'd have a coinsurance, and for days beyond that, you'd pay even more or use lifetime reserve days.
Medicare Advantage (Part C):
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Your plan will likely have its own cost-sharing structure. In your case, you'd pay the $350 copay per day for the first 7 days of a hospital stay.
No Part A deductible:
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When you have a Medicare Advantage plan, you typically don't pay the Part A deductible.
Plan-specific costs:
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It's crucial to check your specific plan details for how it covers hospital stays beyond the first 7 days, as costs can vary significantly between plans.
Medicare Advantage plans set their own cost-sharing terms and may or may not charge deductibles for hospital stays. After meeting the deductible, your Medicare Advantage plan may have a copay for the initial days of your stay.
If you choose in a Medicare advantage plan, you are no longer in original Medicare and that original Medicare deductible does not apply at all
If you have a Medicare supplement plan instead of a Medicare advantage plan, the Medicare supplement plan will pay all hospital deductibles and costs that are approved by Medicare including the deductibles
It works exactly as you are stating. Your Advantage plan has a $350 co-pay for each day you are hospitalized, up to 7 days. If you are in-patient longer than 7 days, there is no charge. When you have an Advantage plan, the hospital deductible is not in effect, only your daily co-pay.
You would pay the $1676 first each year, because it’s your deductible, then for days 1-7 of your hospital stay as long as they were consecutive. If you leave the hospital and come back, the hospital stays start over, and the deductible starts over every year.
It depends on what plan you are choosing. Every state has different coverages. The 350 co-pays is just for the plan you are looking at. There may be better options for you. :-)
If you only had Original Medicare, the Inpatient Hospital Deductible is $1,676, but having a "C" Plan or Medicare Advantage Plan, takes the place of the Original Medicare requirements. In order to be on any plan, you must be entitled to Part A and paying Part B. Then the private insurance companies offer coverage through a "C" Plan or Medicare Advantage Plan or Medicare Supplement Plan. The "C" Plan must cover at least what Medicare covers and can add additional benefits such as dental, vision, hearing and over-the-counter products.
If the Advantage plan has Zero deductible instead and a $350.00 per day copay for in-patient hospital admissions, the member pays $350.00 times the amount of days spent as an admitted patient until the max days are covered, which in this case is 7.
If the stay is more than 7 days all the member pays is for the 7 days. This is different for observation or emergency room stays.
If you are a member of an Advantage plan you do not pay the Pt A deductible. You are only responsible for the hospital copay listed in your plans summary of benefits. So you would pay the $350 per day for days 1-7 as you listed in your question.
