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Medicare Part A

What Does Medicare Part A Cover

When you receive your red, white and blue medicare card, you will find it lists “Medicare Part A Hospital”. Part A basically covers the hospital bed that you occupy as an inpatient along with any services that you receive as a patient. It will also cover a semi private room and your meals. In other words, it covers food and lodging along with your treatment as an inpatient.

 

More On What Medicare Part A Covers

Medicare Part A also covers skilled nursing facility. What is skilled nursing? You know after you have had a surgery such as a hip or back surgery how they do not leave you in the hospital, they generally send you to a specialized rehabilitation facility with specialized equipment and personnel trained to get you back on your feet again. Generally the equipment they use is designed to help you regain your range of motion that has become limited due to the chronic pain leading to your surgery.It involves concentrated health care and medical rehabilitation services with 24 hours supervision for individuals with serious health challenges. Medicare Part A covers skilled nursing services. Many people wonder whether Medicare Part A covers long-term care. At this time Medicare does not cover long term care services however that may become a possibility in the future. If it becomes a coverage under Medicare we will certainly let you know.

 

What Does Medicare Part A Coverage Cost?

Generally Medicare Part A is considered an entitlement and so there is nothing to pay for Part A. Most persons or their spouse have worked enough quarters (40) in their lifetime to qualify for this coverage without any premium or cost. In other words you get Medicare Part A for free when you turn 65 if:

 

  1.  You are already receiving retirement benefits from Social Security or from the Railroad Retirement Board.
  2.  You haven’t filed for the benefits yet, but you are eligible to receive Social Security or benefits from the Railroad Retirement Board.
  3.  You or your spouse were a government employee and it was covered by Medicare.

 

The rules for receiving Part A for free in you’re under 65 are the following:

  • You ‘ve been receiving Railroad Retirement or Social Security disability benefits for at least 24 months.
  • You have what is called End Stage Renal Disease (ESRD) and meet any other requirements.

 

What If I Do Not Qualify for Premium Free Medicare Part A?

If you are required to pay a monthly premium for Part A, you may pay up to $422 each month for this coverage in 2018. The amount you are subject to paying is based on the number of quarters you paid Medicare taxes during your working life. For example, if you paid Medicare taxes for less than the minimum 30 quarters while working, then you will be charged the standard Medicare Part A premium of $422 per month. However if you paid Medicare taxed for 30 to 39 months quarters while working, you can expect the standard Medicare Part A premium to drop to $232 per month. In addition you may also be required to purchase Medicare Part B. For current information about your enrollment in Medicare Part A or Part B, please contact your local Social Security office or go online to ssa.gov to get additional details. Some individuals turning 65 will automatically get Medicare Part A. Learn more about Medicare Part A coverage and when and how you can sign up.

 

When Can I Sign up for Medicare Part A?

If you are already receiving your Social Security income benefits then enrolling into Medicare Part will be automatic. The social security office will mail your medicare card to you without you doing anything.

 

If you’re not yet receiving benefits from Social Security or the Railroad Retirement Board, then you will need to fill out the appropriate forms in order to enroll in Part A when you turn 65. You can contact the Social Security office at or go online to ssa.gov or ssa.gov medicare for more information.

 

What Are My Costs Under Medicare Part A?

The age old question is “What is this going to cost me?” Although Medicare Part A provides coverage for the majority of the expense of being an inpatient in the hospital, you do have some of the cost sharing. Each year these cost sharing amounts are set by the Centers for Medicare and Medicaid (CMS). You also must understand what is meant by a “benefit period”. Under Original Medicare a Benefit Period is used to measure your use of skilled nursing and hospital services. The benefit period begins the day you become an inpatient in the hospital or skilled nursing facility. After you are released or haven’t received any hospital care or skilled nursing care for 60 days in a row the benefit period ends. For example if you’re admitted to the hospital and are released but enter back into the hospital 21 days later, you are still in your same benefit period. However if you’re admitted into the hospital and released, but then re-enter 70 days later it’s a new benefit period. Understanding what a benefit period is key to grasping what your cost sharing will be under Original Medicare Part A.

 

For 2018 the hospital cost sharing for Medicare Part A is the following:

  •  A $1340 deductible for a hospital stay during each benefit period
  •  There is $0 coinsurance for Days 1-60
  •  For Days 61-90 you pay $335 coinsurance per day of each benefit period.
  •  For Days 91 -150 the coinsurance is $670
  •  For Days 150 and beyond you’ll pay any and all costs.

 

For 2018 the skilled nursing facility cost sharing is as follows:

  1.  Days 1-20 Medicare pays all cost
  2.  Days 21-100 you will pay $167.50 per day.

 

There are Medicare supplement policies and Medicare Advantage plans that can help reduce or eliminate your cost sharing. Please contact our Medicare Coverage helpline and speak with a licensed specialist.

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