Medicare Part A
Medicare Part A is health insurance for inpatient care and services. It helps you pay for the services you receive from an overnight stay at:
- Inpatient Hospital
- Skilled nursing facility
- Home health care
Medicare Part A helps with the cost of medically necessary care you receive at these facilities. While there are some restrictions and other qualifications, it generally includes:
- A semi-private room with nursing care and meals
- Diagnostic procedures like laboratory test and X-rays
- Drugs and medical supplies used during your stay
- Operating room services
- Intensive care and other special treatment units
- Physical and occupational therapy (if they’re needed to meet your health goal)
- Speech-language pathology services (if they’re needed to meet your health goal)
- Skilled health care in your home
- Hospice care (for the terminally ill)
All the covered services must be medically necessary, short-term services designed to help you regain your health and mobility.
Medicare Part A doesn’t cover the entire cost of these services. You must contribute to the payment of your own medical bills.
What Medicare Part A Doesn’t Cover
Medicare Part A does not cover some of the services you may receive during a hospital stay including:
- A private room
- Private nursing staff
- Telephone and television charges
- Personal care items, like razors or slipper socks
- Doctor fees (These are covered by Part B)
Medicare Part A Eligibility
If you qualify for Medicare Part A you are eligible for Part B. Together, these are often called original Medicare.
Medicare is an entitlement program. You can’t be refused for Medicare Part A insurance because of your medical history or a pre-existing condition.
Medicare Part A Costs
Most people who receive Medicare Part A do not pay a premium (monthly fee) for their insurance. You may be required to pay a premium if you (or your spouse) did not work enough (40 quarters) for this entitlement benefit.
The only time you pay for your Medicare Part A benefit is when you use it.
Your costs for Medicare Part A include:
- Deductible. For a hospital stay you must pay a deductible for each benefit period. A benefit period begins the first day you are admitted and ends 60 days after you have not received care in a Hospital or Skilled Nursing Facility (SNF)
- Copay. If you stay in the hospital for more than 60 days, you pay a set copay for each day 61-90. Days 91 and beyond is a higher co-pay per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime). Medicare sets the deductibles and copay amounts every year.
Now that you understand Medicare Part A, let’s take a close look at Medicare Part B.