Medicare Part A Costs in 2021

The Centers for Medicare and Medicaid Services has announced Medicare costs for 2021. Everyone, regardless of their income, will be subjected to increases in out of pocket spending. Use these numbers to guide your healthcare expenses in the new year.

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Part A Premiums

Medicare Part A is premium-free for 99% of Americans. This is because most people have paid into the system for years with employee taxes for both Medicare and Social Security. If someone has not contributed 40 quarters (10 years) or more of Medicare taxes, however, they will be required to pay premiums for Medicare as follows.

2021 Part A Premiums
Quarters of Medicare Taxes Paid Your 2021 Costs Change from 2020
40 quarters or more $0 per month No change
30-39 quarters

$259 per month

$3,108 per year

$7 increase per month

$84 increase per year

Less than 30 quarters

$471 per month

$5,652 per year

$13 increase per month

$156 increase per year

It is in your best interest to work up to 40 quarters if possible. This could mean delaying your retirement until you have met enough quarters of federally taxed employment. If you work 40 or more quarters, it could save you tens of thousands of dollars in Part A premiums over your lifetime. This could have a significant impact on your ability to retire comfortably.

The good news is that if you have not worked 40 quarters yourself, you may qualify for free Part A premiums based on your spouse's employment history. This applies as long as you are married or you remain single after divorcing someone you were married to for at least 10 years. You may be eligible to use your spouse's record if you are widowed too. The only rule is that you remain single and were married to your spouse for at least 9 months before they passed away. The rules for ​people who remarry can get a little tricky.

Please note that any money you earn "under the table" will not count towards your eligibility for free Part A premiums since there are no documented taxes.

Part A Deductibles, Copayments, and Inpatient Hospital Stays

Hospital costs and skilled nursing facility costs, not surprisingly, are on the rise. According to the statistics from the latest Kaiser State Health Facts survey, including data from all 50 states and the District of Columbia, each day someone was hospitalized as an inpatient in 2017 cost $2,129 in a state/local government hospital, $2,574 in a non-profit hospital, and $1,996 in a for-profit hospital.

Medicare Part A charges you a flat deductible for each inpatient hospital admission, this includes coverage for​ inpatient only surgeries. This deductible covers all costs up to 60 days with the exception of physician fees which are covered by Part B. After 60 days, you are charged a copayment for each additional day you are hospitalized.

2021 Part A Inpatient Hospital Stay Costs
Day of Inpatient Hospital Care Your 2021 Costs Change from 2020
Inpatient hospital deductible days 0-60

$1,484 per hospital stay

$76 total increase

Inpatient hospital copayment days 61-90

$371 per day

$19 increase per day

Inpatient hospital copayment days 91+

$742 per day

$38 increase per day

Part A Deductibles, Copayments, and Skilled Nursing Facility Stays

Many people will require health care after hospitalization too. If care cannot be safely performed at home, they may require placement in a skilled nursing facility (SNF). In 2019, the average rate for a semi-private room in a nursing facility was $247 per day ($7,513 per month). For a private room, the cost went up to $280 per day ($8,517 per month). That's $90,155 and $102,200 per year respectively. If you live in Alaska, Connecticut, Hawaii, Massachusetts or New York expect to pay more. These are the most expensive states for nursing home care in the country.

Medicare Part A covers the first 20 days of care received at a skilled nursing facility stay immediately following an inpatient hospital stay at no cost to you. Things can get tricky here because some people are placed under observation rather than admitted as an inpatient. Simply staying overnight in the hospital does not make you an inpatient.

2021 Part A Skilled Nursing Facility (SNF) Costs
Day of SNF Care Your 2021 Costs Change from 2020
SNF days 0-20 $0 No change
SNF days 21-100 $185.50 per day

$9.50 increase per day

SNF days 100+ All costs paid out of pocket by beneficiary No change

The bad news is that Medicare does not pay for care that is not associated with a hospital stay. People in need of long-term care will need to find another way to pay for a nursing home. For that reason, many seniors also need to sign up for Medicaid.

A Word from Verywell

If you are lucky, you will never need to use Medicare Part A. You would never need hospitalization, you would never need a skilled nursing facility and you would never need hospice care. Ultimately, it is important to have this coverage should you ever need it and to know how much it would cost.

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Article Sources
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  1. U.S. Centers for Medicare & Medicaid Services. Part A costs.

  2. Kaiser Family Foundation. Hospital Adjusted Expenses per Inpatient Day by Ownership. Published 2019.

  3. Genworth. Cost of Care Survey 2019. Updated August 26, 2019.

  4. U.S. Centers for Medicare & Medicaid Services. Skilled nursing facility (SNF) care.