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What is Medicare Part A?

Medicare Part A

Medicare Part A is one of two parts that makes up Original Medicare, which is the traditional Medicare service offered by the federal government. The two parts of Original Medicare are Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).

Medicare Part A helps to cover a range of hospital care and services for patients in an acute hospital setting, a skilled nursing facility, a long-term care hospital, and in some cases a home setting.

 

Who is Eligible for Medicare Part A?

If you’re at the age of 65 years or older and a legal U.S. resident, you are most likely eligible for Medicare Part A. In addition, some people are eligible for Medicare before turning 65 in the event of disability or illness. 

 

Enrolling in Medicare Part A

If you are already collecting Social Security benefits or Railroad Retirement Board benefits at age 65, then you are automatically enrolled in Medicare Part A at no additional cost. If this applies to you, then three months before your 65th birthday, your Medicare card will arrive by mail. If you aren’t yet collecting these benefits, then you can enroll in Medicare during the open enrollment period in the three months prior to turning 65.

 

 

Medicare Part A Coverage & Benefits

Medicare Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

 

Inpatient Hospital Care:

This relates to the services covered by Part A during your stay in a Medicare-covered hospital.

A doctor must issue that hospital care is necessary for treating illness or injury and the hospital must accept Medicare.  

Hospital services include: semi-private rooms, general nursing, drug treatment, meals, hospital services and supplies. Your doctor may suggest services not covered by Medicare, in this case you may need to pay additional costs. Additionally, any private-duty nurse or private room will require additional costs unless proven medically necessary.

 

Long-Term Care Hospital Services: 

Long-term care services specialize in treating patients that have more than one serious condition and that may improve with time and eventually return home. You will not have to pay an additional deductible for long-term care if transferred directly from an acute care hospital or if admitted within 60 days of a past inpatient hospital stay. Otherwise, if you are past the 60-day threshold, a new benefit period begins. 

 

Skilled Nursing Facility Care:

Skilled Nursing Facility care is health care ministered by a skilled nurse or therapist performed to treat and manage your condition. Part A coverage offers this on a short-term basis if you have a qualifying hospital stay, your doctor has decided you require skilled care on a daily basis, the facility is Medicare certified, and you have days left in your benefit period.

 

Hospice:

If patients are terminally ill, Part A covers care to manage your symptoms and control pain. It also covers respite care and some medical equipment for use at home.

 

Home Health Care:

If you are homebound and in need of skilled care, Part A will cover part-time skilled health care in your home

A licensed agent can answer any questions you may have about Medicare Part A coverage. Connect directly with one of our agents to learn more with no obligation.

 

Medicare Part A Costs

In most cases, people eligible for Medicare Part A do not have to pay a premium. This will apply to you in the following circumstances:

If you are 65 years old and have paid Medicare taxes (FICA) for 10 years. This also applies in the event that your spouse or former spouse has paid FICA taxes for at least 10 years.
If you are a disabled individual and have paid FICA taxes for 10 years, you are eligible for Medicare after receiving Social Security benefits for 2 years. Again, this applies if a spouse has paid the FICA taxes for at least 10 years.
If the above points do not apply, you can still purchase Part A coverage, though you will need to pay a premium. The premium amount will be based on your work history and on how long you or your spouse has been paying Medicare taxes. Purchasing Part A coverage will come with a premium of up $437 per month.

 

If you would like to learn more about Medicare Part A, connect directly with one of our trusted agents. We love assisting with your Medicare needs and ensuring our clients make the best available choices. Prefer to speak by phone? Give us a call today.

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