What is Medicare Part A?

By planmedicare1 - March 10, 2016

Understanding Medicare terms can be confusing for those who are new to Medicare. We at Plan Medicare have defined and answered some frequently asked questions that many have regarding Medicare Part A.

What is Medicare Part A?

Medicare Part A (Hospital Insurance) is part of original Medicare. It is offered by the federal government and overseen by the Centers for Medicare and Medicaid services. Part A covers care from hospitals, skilled nursing facilities (not custodial or long term care), hospice care, and some home health care related services.

Who can get Medicare Part A?

If you are a U.S. citizen or a permanent, legal resident of the United States, and you are (or are turning) 65 years old, you are eligible for Medicare Part A. Additionally, people under the age of 65 with certain disabilities, and people with End-Stage Renal Disease are entitled to receive Medicare Part A.

When and how can I sign up for Medicare Part A?

Most people will get Medicare Part A automatically during their Initial Enrollment Period (IEP). If you are automatically enrolled, you will receive your red, white, and blue Medicare card in the mail 3 months before your 65th birthday (or the 25th month of your disability). Some people will need to sign up for Medicare Part A if you are not collecting Social Security or Railroad Retirement Board benefits.

If you did not sign up for Medicare Part A when you were first eligible, and you do not have a special circumstance to enroll midstream, you will need to sign up during the General Enrollment Period (GEP), which is January 1st- March 31st of each year. If you enroll during GEP, your coverage will start July 1st of that year.

What does Medicare Part A cost?

For many, Medicare Part A is free, provided that you or your spouse has paid Medicare taxes while employed. If you or your spouse are not entitled to “premium-free” Part A, you may be able to purchase it.

What does Medicare Part A cover?

Medicare Part A coverage includes:

  • Inpatient care in hospitals
  • Hospice care
  • Skilled nursing facility care
  • Home health services and nursing home care may also be covered (if deemed medically necessary)
  • Blood transfusions are also covered (after the individual has paid for the first 3 pints of blood)

What does Medicare Part A not cover?

Medicare Part A does NOT cover:

Hospitalization Deductibles & Copayments:

  • For the first 60 days under hospitalization service the individual will have a $1,216 deductible
  • For days 61-90 days under hospitalization service, Medicare pays all but $304 per day of each benefit period
  • For days 91 and beyond under hospitalization service, Medicare pays all but $608 per day of each benefit period

Skilled Nursing Care Deductibles & Copayments:

  • Medicare pays all approved amounts for the first 20 days
  • For days 21-100, Medicare pays all but $152 per day
  • For days 101 and beyond, Medicare pays $0 (You pay all costs)

Additional Benefits

  • Care provided by a non-medically trained person at a nursing facility
  • Most dental care
  • Eye examinations related to prescribing glasses
  • Dentures
  • Cosmetic Surgery
  • Hearing aids and exams for fitting them
  • Routine foot care
  • The cost of the first 3 pints of blood required during a blood transfusion

 

These limitations can, however, be covered by purchasing a Medicare Supplemental Plan.

If you have questions in regards to Medicare Plan A, or are interested in additional information about Supplemental plan options please contact one of our licensed Medicare experts at PlanMedicare.com

Speak to a Licensed Advisor in Medicare today

Book an Appointment Call: 516-900-7877