Medicare’s Part A Trust Fund Is Projected to Run Short in 2033: 6 Costs Seniors Should Watch

Medicare’s Part A Trust Fund is projected to face a funding shortfall in 2033, making it important for seniors to monitor hospital, skilled nursing, hospice, and supplemental insurance costs. Jelena Stanojkovic/Shutterstock

Approximately 67.5 million people depend on Medicare Part A in the United States, which provides patients with essential hospital insurance coverage. Part A typically covers inpatient hospital stays, skilled nursing facility care, hospice, and some post-acute home health care. Like Social Security, Medicare’s Part A Trust Fund is facing shortfalls. Recent reports project that Medicare’s Part A Trust Fund could start to run short in 2033, meaning it will be unable to cover 100% of its obligations by that time. That’s less than seven years away, and both Medicare recipients and soon-to-be retirees are wondering how it will impact their long-term retirement planning. While Medicare isn’t going to disappear, here are six costs seniors should keep a close eye on.

1. Higher Hospital Cost-Sharing Could Become a Reality

As mentioned above, Medicare Part A helps cover inpatient hospital stays after beneficiaries meet their deductible requirements. If lawmakers decide to work on reforms to strengthen the trust fund, increased deductibles or higher cost-sharing requirements could become part of future discussions. While no specific changes have been approved, beneficiary cost-sharing is commonly looked at as one potential solution. That said, seniors who experience multiple hospitalizations in a year could feel the greatest impact from any future adjustments.

More frequently, financial advisors are urging seniors to have a dedicated emergency fund for healthcare costs. It is one of the highest expenses seniors face in retirement, and with changes happening with Medicare, that price tag could continue climbing.

2. Skilled Nursing Facility Expenses May Receive More Scrutiny

Much of the time, patients need skilled nursing care following a hospitalization. Sometimes, this means moving into a facility for a period of time or having nurses come to your home. Either way, it can be incredibly expensive, and it catches many seniors off guard. In the United States, skilled nursing care averages $8,800 to $11,300 per month. Part A would typically cover limited stays in skilled nursing facilities under specific circumstances. But coverage rules have changed over time and will likely continue evolving.

To maintain access and affordability, some serious changes would need to happen. If reimbursement rates change in the future, it is possible that some facilities may adjust pricing structures or availability.

3. Supplemental Insurance Premiums Could Rise

Medigap and Medicare Advantage plans have been leaned on by many seniors to cover the gaps in their coverage. With trustees also concerned about the Social Security fund running out, seeing supplemental insurance premiums rise isn’t ideal, but it is a total possibility. Increased healthcare costs often influence insurance premiums across the healthcare landscape. While the Part A trust fund itself does not directly determine Medigap pricing, broader healthcare spending trends can affect what insurers charge consumers.

It’s important for seniors to review their supplemental coverage every year. Don’t just automatically renew. Taking the time to compare plans could help you save some money, and with funds running short, you’ll need every penny you can get in your pocket.

4. Hospice Care Costs Deserve Closer Attention

Roughly 18% of the American population is 65 or older, and as Americans age, the demand for hospice care continues to grow. This puts even more pressure on already-stressed Medicare spending projections. Trustees have identified rising expenditures in several Part A-covered services as contributing factors to the trust fund’s financial outlook. Although Medicare currently covers many hospice-related costs, future policy discussions could examine reimbursement structures and eligibility requirements.

If you’re planning for the future, it’s important that you stay on top of the latest information regarding end-of-life care. Again, it’s key to have emergency savings set aside. You should also have open conversations with your family about your wishes if you are ever put on hospice care. Having these discussions early can help with planning.

5. Access to Certain Providers Could Become More Challenging

When changes happen to Medicare, many patients lose access to certain providers. In some cases, they may have seen that specific doctor for years, but it doesn’t matter. If the provider no longer participates, you can’t access them using your Medicare plan. Estimates say that revenue would cover about 89% of projected Part A costs after depletion if no reforms occur. Ultimately, reduced payments to hospitals and providers could create operational challenges, especially in rural or underserved communities.

This doesn’t mean that providers would stop accepting Medicare patients, but it could create access issues in certain areas throughout the country. So, it is crucial that you pay attention to healthcare availability in your area. Keep your ear to the ground about any potential changes near you when it comes to who is accepting Medicare and who isn’t. This will help you maintain relationships with trusted providers that will always be covered.

6. Long-Term Care Planning May Become Even More Important

Many retirees mistakenly assume Medicare will cover all long-term care expenses. In reality, Medicare’s coverage of extended custodial care is already limited, and future funding pressures could increase the importance of personal planning. The projected depletion of the Part A trust fund does not automatically mean benefits disappear, but it highlights the importance of preparing for healthcare expenses that Medicare may not fully cover.

Consider healthcare projections when you are planning for retirement, alongside housing and everyday living costs. Having a realistic strategy today can reduce stress and provide greater flexibility later.

What Can Be Done?

When it comes to the Medicare Part A Trust Fund, trustees have pinpointed a few things that could be done to address the solvency gap. However, it involves changes that no one really wants to see happen. Policymakers would have needed to reduce scheduled benefits starting in January 2026 by 12% (that didn’t happen).

The second option? They could increase the Medicare payroll tax from 2.90% to 3.46%. While that’s not ideal, it could be the only option policymakers have, but they still haven’t taken action on that yet either.

“Americans pay into Medicare with every paycheck, and seniors have done their part,” Bill Sweeney, AARP’s senior vice president of government affairs, said in an interview. “Now it’s time for Washington to protect Medicare. That means not only addressing the hospital trust fund but also lowering premiums and bringing down drug prices. Congress has faced this challenge before and always found a way through it.”

So, what are seniors supposed to do? The projected funding shortfall is a serious issue, but you shouldn’t panic. Historically, Congress has acted when major entitlement programs approached funding challenges. There will likely be reforms made before full depletion occurs. Additionally, the Trustees Reports indicated that Medicare would still collect substantial revenue even after trust fund reserves are exhausted, which will allow the program to continue paying a significant portion of benefits. At this time, the smartest move for retirees is going to be to stay informed, review healthcare costs regularly, and build flexibility into their retirement budgets.

Are you concerned about Medicare’s long-term future, or do you believe Congress will act before any major changes occur? Share your thoughts in the comments below.