I don’t know for sure but I’m guessing, you get as confused as me about all these different lettered Medicare parts and plans.
I mean, do we really need a Medicare Part A and a Medicare Supplement Plan A, sometimes I think someone is sitting back laughing to themselves thinking…I only suggested those names as a joke.
Well whether that is true or not, I can at least help you clear up any confusion about Medicare Part A in just a few quick minutes.
Because I am going to answer the three most commonly asked questions about Medicare Part A:
- 1What is Medicare Part A?
- 2What does Medicare Part A cover?
- 3How much does Medicare Part A cost?
What Is Medicare Part A?
When you think, ‘What is Medicare Part A?’, all you have to remember is, this is my Hospital Insurance.
Generally speaking, Medicare Part A will cover all of your inpatient care, including hospitals, skilled nursing facilities and in very limited cases, at home care.
Basically, Part A covers the following four circumstances:
- 1Hospital Care
- 2Skilled Nursing Facilities
- 3Limited in-home care
- 4Hospice Care
Medicare Part A Eligibility
The great thing about Medicare Part A is that if you are eligible for Medicare benefits, then you are automatically enrolled by your 65th birthday.
You should receive your Medicare red, white and blue card a few months before your 65th birthday.
You will officially be enrolled the 1st day of the month of your 65th birthday.
For instance, if your 65th birthday is on February the 15th, then you will be enrolled for Medicare Part A effective on February 1st.
If your birthday happens to be the 1st day of the month, then your enrollment will go into effect the 1st day of the month before your birthday.
What Does Medicare Part A Cover?
Because we tend to think of inpatient services as hospital or nursing home stays, it can get confusing when we talk about Medicare Part A also covering in home care.
So what does Medicare Part A cover?
Medicare Part A covers all of your inpatient services, including a semi-private room, food, medicines, doctor/nurses, and treatments.
Keep in mind that Part A does not include private rooms, private nursing or your personal items that you may use at the hospital.
It also does not cover the cost of blood but you will only be required to pay for the first 3 pints if you do need it.
Remember that in addition to Medicare Part A, Part B, Part C, and Part C, there are also Medicare Supplement plans that will cover the cost of the blood and cover other areas that Part A does not include in its policy coverage.
Home Health Care
Medicare’s home health care program requires a doctor to order services because it is medically necessary.
The level of home care services you receive will be determined by the doctor and would only include 24-hour nursing care if necessary.
The coverage would not include your meals, daily care including bathing or dressing, if those are the only limitations that you have.
Finally, for these services to be given to you at home, your doctor must certify you as ‘homebound’.
Essentially, ‘homebound’ is exactly as it sounds, the doctor certifies that it is medically inadvisable for you to leave your home and even if you wanted to you can’t leave your home on your own without substantial help.
To qualify for Medicare Part A to pay for your skilled nursing facilities, you must stay for a minimum of 3 days at a Medicare certified facility.
Your doctor must certify that you need daily skilled ongoing care that would be difficult to render at home, such as IV fluids and/or physical therapy.
If your doctor determines that you have 6 months or less on this earth, you can be eligible for hospice care.
The hospice care may be in a skilled nursing facility but is normally provided at you home.
To receive hospice care you must waive all curative treatments but will still receive palliative care to help keep you pain free and comfortable.
How Much Does Medicare Part A Cost?
Usually, Medicare Part A premiums are free so long as you have worked 10 years (40 quarters) and paid your Medicare taxes in the United States.
This is usually called premium-free Part A and even if you did not complete the entire 40 quarters, in some instances, if your spouse completed more than 40 quarters and paid Medicare taxes, you may still be eligible for free Part A.
If you do not qualify for free Part A coverage, you can still enroll and pay a premium.
So, how much does Medicare Part A cost?
If you worked less than 30 quarters then you will pay the full premium of $437.00 per month for 2019.
If you worked 30 –39 quarters you will pay a smaller premium of $240.00 per month for 2019.
In addition, you are responsible for a $1,364 deductible each year.
Keep in mind that some of the Medicare Supplement Plans will cover most of your out of pocket expenses.
Be sure to discuss Medigap Plans in conjunction with Medicare Parts with your Senior Benefits Agent.
Now that you have a much better understanding of Medicare Part A and what it covers, it’s time to discuss your situation with a Senior Benefit Services expert.
There is a limited time you are eligible to enroll during your one-time open enrollment period or the costs of Medicare Supplement coverage can increase dramatically.
Contact Senior Benefit Services today to find out what the best combination of coverage’s are for you.