What is Medicare Part A?

Medicare Part A:

Qualification, Coverages and Costs

Part A of Medicare is your hospital coverage, and together with Part B (medical coverage) they make up Original Medicare. Understanding each part in its entirety can be overwhelming, but this article will easily immerse you in what Medicare Part A is, what it covers, who qualifies for this free part, and how to enroll.

Qualification and registration

Most people automatically qualify for Medicare Part A at age 65 if they are already collecting retirement benefits from the Social Security Administration or the Railroad Retirement Board. You may also qualify for Medicare Part A before age 65 if you have a disability, end-stage renal disease (ESRD), or amyotrophic lateral sclerosis, better known as Lou Gherig’s disease.

For most people, Medicare Part A is free, assuming you paid your Social Security taxes for a period of 10 years or 40 quarters. If you don’t qualify for premium-free Part A, you can buy it for up to $458 each month. If you paid Medicare taxes on less than 30 rooms, the standard Part A premium is $458. If you paid Medicare taxes for 30-39 rooms, the standard Part A premium is $252.

But if you are not yet receiving Social Security or Railroad Retirement benefits, you will need to manually enroll in Part A no earlier than 90 days from your eligibility date, which is typically the first day of the month you turn 65. Enroll in Medicare Part A by contacting the Social Security Administration by phone at 800-772-1213 or online at www.ssa.gov. You can also contact one of our agents at Avila Medicare for help with your Part A enrollment.

Coverages and costs

As already mentioned, Medicare Part A takes care of your hospital coverage, but what does this part really cover? This includes inpatient hospital care, skilled nursing facility care, hospice care, home health care, and some nursing home care. Approved nursing home care includes hospital care in a skilled nursing facility that is not considered long-term care.

For more detail, with Medicare Part A, if you are hospitalized or need to stay in a mental health facility, you will first need to pay the Part A deductible which is $1,484 per benefit period. This means that each time you are admitted to the hospital or mental health facility as an inpatient, you will have to pay the first $1,484. Once this deductible is met, your coinsurance is $0 for the next 60 days as an inpatient. If your inpatient stay is longer than 60 days, then you will have a coinsurance of $371 per day for days 61-90 of each benefit period and $742 per day for each day beginning on day 90 up to a maximum of 60 days. additional. These additional 60 days are known as your “Lifetime Reserve Days” and after these additional days, you will be responsible for all costs.

Part A covers you up to a maximum of 20 days at no cost, when you are admitted to a skilled nursing facility, but from days 21 to 100, you will be responsible for the copayment of $185.50 per day and after day 100, you will pay all the costs. Among the things that Medicare Part A also covers is hospice stay with a $0 coinsurance, but you may have a $5 copay for any prescription drugs while in hospice care.

Finally, under Medicare Part A you also have no coinsurance for Medicare-approved home health care, but you will have to pay 20% of the cost for any Medicare durable equipment that is needed.

What does Medicare Part A not cover?

Among the things that Medicare Part A does not cover are long-term care, most dental care, eye exams, dentures, cosmetic procedures, acupuncture, hearing aids, and routine foot care.

As you can see, while Medicare Part A offers good coverage, it leaves you exposed to some expenses, including the Part A deductible and various coinsurance and copayments. For this reason, many of our clients choose a Medicare or Medigap supplemental plan to help cover these costs and protect their income and savings. (To learn more about the different Medigap plans available, check out our series of videos on YouTube that cover all the available plans.)

For more information on Part A enrollment or Medigap policies, contact one of our authorized agents for a free consultation at 855-GO-AVILA. That is 855-462-8452. Or just click the button below to request information now.