Medicare Part A
Original Medicare includes Part A hospital insurance coverage & Part B medical insurance coverage.
Each part of Medicare covers different types of services and has different benefits.
Below we’ll discuss Part A and give you answers to some frequently asked questions.
What is Medicare Part A – Hospital Coverage
The federal government provides Medicare Part A health insurance to U.S. citizens, as well as legal immigrants, who’ve resided in the country for a minimum of 5 years.
Part A includes coverage for inpatient care services received during a hospital stay or emergency room services received in a skilled nursing facility. In some cases, you may receive coverage for at-home care.
Medicare Part A Qualifying Health Coverage (QHC) under the Affordable Care Act. Those with Part A may receive a 1095-B Form from Medicare. You don’t need this form to file taxes, you can file taxes without it.
Who is Eligible for Part A
Most citizens meet the Part A eligibility requirements at age 65. Usually, you become automatically eligible once you reach the age of 65 and receive benefits from the Railroad retirement board or the Social Security Administration.
If you have a disability, End-Stage Renal Disease or Amyotrophic Lateral Sclerosis, you may be eligible before you turn 65.
What Does Medicare Part A Cover
Part A coverage benefits include:
- Inpatient hospital care: Part A hospital coverage might include benefits for the care you receive at an inpatient mental health hospital, long term care hospitals, critical access hospitals, and acute care hospitals. It also may include coverage for semi-private rooms, nursing services, meals, and some prescription drugs.
- Skilled Nursing Facility care: you might receive coverage for daily skilled nursing care if medically necessary as well as coverage for a semi-private room, meals, medical supplies, transportation via ambulance and prescription drug medications.
- Home health services: Coverage for services such as at-home skilled nursing care, part-time home health care, therapeutic services, physical therapy, and occupational therapy.
- Hospice care (more information below)
- Care in special units: such as intensive care
- Operating and/or recovery room
- Homebound care: part-time skilled care
What Does Medicare Part A Not Cover
Part A does not cover extras like private duty nursing or private hospital rooms unless they’re medically necessary. Part A will helps pay for care in a long-term care facility; however, not all custodial care such as help with bathing and feeding has coverage.
What is the Part A Deductible
As of 2020, the Part A deductible is $1,408.
The Part A deductible works like many other health insurance policies in that you must meet the deductible and pay a portion of your costs, known as “coinsurance.
These costs correlate to “benefit periods”; which begin on the first day in the hospital and end when you haven’t had inpatient care for 60 days.
All supplement plans reduce yours out of pocket costs for deductibles, coinsurance, and copayments.
The majority of Medicare beneficiaries sign up for a Medicare Supplement plan as soon as they’re enrolled in both Part A and B.
By doing so, they receive peace of mind knowing most, if not all, of their medical costs, will be covered. Fill out the form you see to the side to compare rates in your area or call the number above for more information on supplement plans for Medicare.
When Can I Sign Up for Part A
If you turn 65 and are already getting Social Security benefits, you’ll automatically receive Part A.
Those that don’t have automatic enrollment, you can sign up for Part A during a 7-month period that begins three months before the month you turn 65; then, it includes the month of your birthday and ends three months after.
Beneficiaries that don’t sign up for Part A during this 7-month time frame have to wait until the next General Enrollment Period; which runs from January 1-March 31 each year.
If you don’t sign up when you’re first eligible, you may have to pay a late enrollment penalty.
You may qualify for a Special Enrollment Period if you are covered by employer-sponsored insurance when you turn 65.
What is the Difference Between Medicare Part A & Part B
Part A covers your medical costs while in the hospital, Part B covers your medical costs at the doctors’ office.
Does Medicare Pay for Hospice
If your primary physician diagnoses you with a terminal illness with a life expectancy of 6 months or less, you may be eligible for Hospice Care coverage.
If a beneficiary is under Hospice Care, Part A may include additional benefits that are not normally covered for the grief of spiritual counseling.
Hospice Care services are normally received in the patient’s home and include some of the below benefits:
- Hospice services
- Physical or Occupational therapy
- Short term inpatient care
- Short term respite care
- Social services
- Pain relief management
- Nursing Care
- Doctor Care
- Medical supplies
There is a copay of us to $5 for each prescription to manage symptoms. There’s also coinsurance for inpatient respite care to give primary caregiver rest or time off.
Does Medicare Cover Palliative Care
Palliative care is part of hospice care benefits.
Palliative care eligibility is possible; however, you must have a diagnosis of terminal illness with an expectancy of six months or less.
Coverage will include treatments for pain management and treatments to make you as comfortable as possible. However, you’ll be required to give up all other medicinal services.
Is Part A Free
Most people don’t pay a monthly premium for Part A. If you didn’t pay 40 quarters of Medicare taxes while you were working, you may have to pay a premium for Part A coverage.
Part A is free at age 65 if you’re eligible for Social Security benefits or Railroad Retirement Board benefits, or if you or your spouse had government employment covered by Medicare.
Beneficiaries who are 65+ who have fewer than 40 quarters of contributions, as well as certain people with disabilities, pay a monthly premium for Part A.
If you paid into Medicare for at least 30 quarters, your Part A premium will be $252.
If you have less than 30 quarters, you may end up paying the full premium, which is $458 a month.
How to Compare Medicare Plans Online
At MedicareFAQ, we love helping you get the best medical coverage at the most affordable rate! Call us at the number above to find the policy that will compliment your Original Medicare.
To compare Medicare plans online in your area, fill out our rate form!