Medicare Part A

Medicare Part A is a core component of Original Medicare, primarily offering hospital insurance. It provides coverage for various hospital-related services, including full coverage for certain home healthcare services. Generally, Part A includes coverage for inpatient hospital stays, skilled nursing care, hospice care, and some home healthcare services.

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Part A Coverage Includes

Inpatient Hospital Care

This covers tests and treatments during a hospital admission. It encompasses services such as meals, nursing care, physical therapy, and prescription medications prescribed by a doctor.

Limited Home Healthcare

After being discharged from a hospital, Medicare Part A covers necessary care provided by home health aides as you recover. This coverage is limited to medically essential care.

Hospice Care

Medicare Part A covers hospice care for individuals who choose this option instead of continuing hospital treatment for a terminal illness.

Short-Term Skilled Nursing Facility Stays

Coverage for stays in a skilled nursing facility is available under Part A, but only for a specified duration. To qualify, you must have had a hospital stay of at least three days for a related condition. The skilled nursing facility must be Medicare-certified to be covered under Part A.

Nursing Home Care

This is covered for a limited period, specifically for short-term needs following a hospital stay.

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What Medicare Does Not Cover

Blood Costs: Part A does not cover the first three pints of blood you receive. However, if the blood is obtained from a central blood bank, you may not be charged by the hospital for these pints.
Private Rooms: Medicare Part A does not cover the cost of a private room. Typically, inpatient hospital care is provided in a semi-private room.
Long-Term Care: For long-term care needs, such as extended nursing home stays, Medicare Part A does not provide coverage. Part A is designed to cover care related to acute illnesses or injuries, and you will need to pay out of pocket for long-term care services.

Medicare "Must-Know" Information

medicare COST

Most people who qualify for Medicare do not have to pay a premium for Part A, provided they or their spouse have worked and paid Medicare taxes for at least 40 quarters (10 years). If you do not meet this requirement, there are specific cost details to be aware of for hospitalization:

Lifetime Reserve Days: For inpatient hospital stays beyond 90 days, Medicare Part A provides 60 lifetime reserve days. If you exceed these 60 days, you are responsible for all costs after day 91.
Benefit Period: A benefit period begins with your inpatient admission and ends when you have not received inpatient care for 60 consecutive days.
During a benefit period: Days 1-60 of inpatient care are covered at $0 per day.
Days 61-90 are covered at $389 per day.
Days beyond 90, using lifetime reserve days, are covered at $778 per day.

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medicare Part A Eligibility

To qualify for Medicare Part A, you must meet one of the following criteria:

Be 65 years old or older.
Have a disability as determined by a doctor and have received Social Security benefits for at least 24 consecutive months.
Have been diagnosed with End-Stage Renal Disease (ESRD).
Have been diagnosed with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.
If you are under 65 and already receiving Social Security benefits, you will be automatically enrolled in both Medicare Part A and Part B when you turn 65.

medicare Part A enrollment

To qualify for Medicare Part A, you must meet one of the following criteria:

Be 65 years old or older.
Have a disability as determined by a doctor and have received Social Security benefits for at least 24 consecutive months.
Have been diagnosed with End-Stage Renal Disease (ESRD).
Have been diagnosed with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.
If you are under 65 and already receiving Social Security benefits, you will be automatically enrolled in both Medicare Part A and Part B when you turn 65.

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