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Medicare Part A

Original Medicare consists of two main parts- Part A and Part B. Part A is hospital insurance and covers services that are related to inpatient services.

What Medicare Part A Covers

Since Part A is hospital insurance, it provides coverage for services that are listed below:

  • Inpatient hospital care: This involves all care you receive after a physician admits you into a hospital. Medicare covers up to 90 days for each benefit period in a normal hospital. Additionally, you get 60 lifetime reserve days. Plus, it covers up to 190 lifetime days in a psychiatric hospital that is Medicare certified.
  • Skilled nursing facility care: Medicare covers your room and board, and some services provided in a skilled nursing facility. These include tube feedings, wound care, and medications. Medicare covers up to 100 days of each benefit period. In order to qualify, you need to have spent at least three ensuing days in the hospital within 30 days of admission to a skilled nursing facility. Plus, you must have required skilled nursing or therapy services.
  • Home health care: While Part B typically covers this, Part A coverage will ensue if you have spent at least three successive days in the hospital within 14 days of receiving home care. Medicare covers up to 100 days of daily care or an unlimited amount of periodic care.
  • Hospice care: beneficiaries qualify for hospice care if they meet these requirements:  your doctor determines that you are terminally ill (life expectancy of 6 months), you want palliative care instead of hospital care to cure the illness, or you sign that you want hospice care instead of treatment in hospital 

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Eligibility for Medicare Part A

In most cases, people are eligible at age 65 if they are already collecting retirement benefits from the Social Security Administration. If you are collecting Social Security you will be automatically enrolled in Part A and Part B. You can also qualify if you have end-stage renal disease, a disability, or amyotrophic lateral sclerosis (aka Lou Gehrig’s disease). You have to be either a U.S. citizen or a legal permanent resident of at least five consecutive years. You don’t have to be 65 if you are eligible because of certain disabilities that are listed above. However, if you have a disability and are younger you must receive Social Security Disability benefits for at least 24 months to qualify.

 

Medicare Part A Cost

  • Part A typically has no cost. You paid specific taxes during your working years that were meant for future Medicare coverage. If you have worked for at least 10 years in the U.S., you will not pay anything, most of the time because you qualify for Part A premium. If you have worked less than 10 years, you can still purchase Medicare Part A as long as you have been a legal resident or have obtained a green card for at least five years. If you have worked from 0 to 29 quarters you will pay 278$ for the Part A premium, and if you have worked lesser than that you must pay the full cost which is 506$ in 2023.

    After you pay your Part A deductible, which is 1600$ in 2023, you have 0$ of coinsurance from 1 to 60 days for a hospital stay. After 90 days, coinsurance is 400$ per day and if you need to stay in the hospital longer than 120 days your coinsurance will be 778$ per day for each benefit period. However, beneficiaries have 60 lifetime reserve days in the hospital, but once you use those reserve days you can’t use them again.

    You can still qualify for Part A premium if you have coverage through your spouse who has paid Medicare taxes regularly, or from your ex-spouse, if you were married at least 10 years before the divorce. If you are widowed you can still qualify for Part A free premium if you were married at least nine months before your spouse passed away.

    If you have additional questions about your Medicare coverage contact our insurance brokers on 830-308-8953.