Medicare Part A is also referred to as Hospital Insurance.
Medicare Part A (Hospital Insurance) covers hospital services, including semi-private rooms, meals, general nursing, drugs as part of your inpatient treatment, and other hospital services and supplies. This includes the care you get in these facilities:
It also includes inpatient care as part of a qualifying clinical research study and inpatient mental health care given in a psychiatric hospital or other hospital.
When should I enroll in PART A?
You should enroll in Part A as soon as you are eligible. The majority of people are not eligible till they turn age 65. If you are receiving Social Security or Railroad Retirement Disability Benefits for more than two years you may also be eligible.
How much does PART A cost?
For the majority of people there is no cost to enroll in Part A. However, if you or your spouse have not worked at least 10 years in a medicare tax paying job you may have a premium for Part A.
IMPORTANT NOTE: Not enrolling in Medicare when you are first eligible will likely result in a permanent penalty and a serious lapse in coverage. If you have already missed your initial enrollment period we can help you minimize the penalty and get temporary health coverage.
How do I enroll in PART A?
If you are currently receiving Social Security Income or Railroad Retirement Income you will likely not need to do anything and will be automatically enrolled when you turn 65 or are in your 25th month of disability. However, if you are not receiving either of the previously mentioned funds you will need to contact Social Security via phone, in-person, or online. To enroll online visit the Social Security website https://www.ssa.gov/medicare/
Okay, I’ve been enroll in PART A and PART B now what?
If you stop with just PART A and PART B coverage you will be responsible for:
Part A and Part B deductibles
Part A and Part B co-insurance and co-pays
100% of the cost of your prescription and drug costs (a few exceptions for hospital settings and Dr’s office)
The out of pocket cost to you could be unlimited if you stopped here, but fortunately you have options:
Enroll in a Medicare Supplement Plan
Enroll in a Medicare Advantage Plan (MA or MAPD)
Enroll in a Medicare Prescription Drug Plan (PDP)
Below is a basic chart of what Medicare Part A covers.
Current Medicare Part A information for year 2017
|Services 2017||Medicare Pays|
Semiprivate room and board, General Nursing, and miscellaneous services and supplies First 60 days
All but $1316 deductible
|61st through 90th day||All but $329 a day|
|91st day and after:
While using 60 lifetime reserve days.
All but $658 a day
|Once lifetime reserve days are used:||$0|
|SKILLED NURSING FACILITY CARE*
You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare-approved facility within 30 days after leaving the hospital.
First 20 days
All approved amounts
|21st through 100th day||All but $164.50 a day|
|101st day and after||$0|
First 3 pints
You must meet Medicare’s requirements, including a doctor’s certification of terminal illness.
|All but very limited co-payment/coinsurance for outpatient drugs and inpatient respite care|
|*A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and skilled care in any other facility for 60 days in a row|