WHAT IS MEDICARE PART A?
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If you have held insurance coverage in the past through your employer, understanding the different parts of your coverage may be a new experience. The different parts of Medicare help its recipients determine the different types of coverage offered and how those benefits apply. With four main parts of Medicare health insurance coverage, this can become confusing. Here, we’ll explain Medicare’s various parts so you can better understand their benefits.
Let’s get started with Medicare Part A: Hospital Insurance.
Medicare Part A eligibility
The original Medicare program includes Part A (hospital insurance) and Part B (Medical Insurance). Original Medicare, (Medicare Parts A and B) have differences in costs and coverage, but enrollment and eligibility are generally the same. You are eligible for Medicare if you are a citizen of the United States or have been a legal resident for at least 5 years and:
- You are age 65 or older
- You are already receiving retirement benefits
- You are disabled and receiving disability benefits
- You have end-stage renal disease (ESRD)
- You have amyotrophic lateral sclerosis (Lou Gehrig’s disease or ALS)
What does Medicare Part A cover?
Most people are automatically eligible for Medicare Part A (hospital insurance) when they turn 65 if they’re already collecting retirement benefits from the Social Security Administration or the Railroad Retirement Board. When you apply to Medicare, you are automatically enrolled in the Part A plan. Part A covers about 80 percent of your inpatient costs.
Generally, Part A helps cover the hospital charges and most of the services you receive if you’re admitted to the hospital for up to 100 days. Let’s look at some of the things you can expect coverage for with Medicare Part A:
- Inpatient hospital stays
- Skilled nursing care
- Hospice care
- Limited home health-care services
Essentially, Medicare Part A shares some costs of care if you need to be hospitalized. However, as a patient, you may still have out-of-pocket costs for the received care. Typically, someone with Medicare Part A coverage can expect to pay a deductible and coinsurance or copayment for the services received.
WHAT DOES PART A COVERAGE LOOK LIKE?
Now that we know some of the things covered by Part A let’s examine how coverage may apply. Medicare Part A helps provide coverage for things you may need while receiving inpatient hospital care. Here are some common services covered under Medicare Part A:
- Semi-private rooms
- Meals
- General nursing
- Drugs as part of your inpatient treatment
- Other hospital services and supplies
WHAT ISN’T COVERED?
Like any healthcare policy, there are limits to the coverage provided by Medicare Part A. Expenses that Part A does not cover are:
- Outpatient doctor’s office visits
- Prescription drug coverage
- Eye exams and dental care
- Long term facility care
- Private-duty nursing
The different parts of Medicare (Part B, Part C, Part D) help provide coverage for the gaps in Medicare Part A. If you need more than the basic coverage offered, you have the option to purchase additional coverage benefits.
The first option is a Medicare Advantage plan with or without prescription coverage. This option completely replaces your Part A and B coverage with private health insurance.
Explore your other options The second option is a Medigap insurance policy combined with a Part D plan.
What will my premiums cost?
A couple of factors determines the cost of your Medicare Part A premium. Medicare Part A is free if you:
- Have at least ten years of work in any job where you paid Social Security taxes in the U.S.
- Are eligible for Railroad Retirement benefits
- Or, have a spouse that qualifies for premium-free Part A
Individuals who aren’t eligible for premium-free Medicare Part A can still enroll in Part A for a cost. Beneficiaries (you) who delay enrollment after they first become eligible for Medicare Part A may be subject to a late enrollment penalty once they sign up.
Explore Your Options
Schedule your appointment today to learn more about your Medicare Part A eligibility and enrollment.