Sometimes, Part A of Medicare can be a little confusing. But it doesn’t have to be that way. We can help you learn everything you need about your Medicare Part A options and benefits.
What is Medicare Part A?
Medicare Part A is also known as “hospital insurance.” But that doesn’t mean your medical care is limited to a hospital stay. It covers a wide range of services both inside a hospital and out (but more on that later).
Most people don’t have to pay for it. Still, every Medicare beneficiaries circumstances are different, and you may have to buy into this coverage if you have a short work history.
How Much is Medicare Part A?
Suppose you have a work history of at least ten years (or 40 quarters) long; congratulations! Your Medicare Part A benefits are free. But if your work history is not quite that long, for better or worse, you will have to buy into Part A.
There is a required monthly premium, and that cost will vary depending on your work history. Beneficiaries who’ve less than 30 quarters of their work history will pay $506 per month for Part A. The monthly premium for beneficiaries with at least 30 quarters is $278.
Who’s Eligible for Part A?
Suppose you’re about to turn 65 years of age and currently receiving Social Security benefits. In that case, your enrollment will be automatic, and you should receive all of your essential documents in the mail.
They should arrive within three months before your 65th birthday. Contact your local Centers for Medicare & Medicaid Services office if you don’t receive your documents.
People under the age of 65 with a severe medical illness, such as End-Stage Renal Disease, are likely eligible for Medicare Part A. Contact your local Centers for Medicare & Medicaid Services Office for more information.
If you’re not currently receiving Social Security benefits, you will have to enroll on your own. Even if you’re currently employed, enrolling in Part A as early as possible can protect you from late enrollment penalties later in life. So it’s a good idea to enroll even if you don’t think you need it yet.
What Does Medicare Part A Cover?
Your “hospital insurance” will cover hospital stays. Specifically, it covers inpatient hospital stays. There may be situations in which you get treatment at a hospital but aren’t considered inpatient.
Therefore, Part A does not cover your care. But as long as you’re admitted to the hospital, Medicare Part A should cover your costs.
In addition to those benefits, Medicare Part A covers:
- Skilled nursing facility care
- Home health care services
- Short-term nursing home care
- End-of-life hospice care
- A semi-private hospital room
- Prescription drugs (as part of inpatient treatment)
- General Nursing
- Other hospital services and supplies
What Does Medicare Part A Not Cover?
For starters, Medicare Part A does not cover outpatient medical care – including regular check-ups, doctor visits, or simple outpatient surgeries. There are some other medical benefits that Medicare Part A does not cover even if you do receive legitimate inpatient care, such as:
- Private duty nursing
- Personal care items
- Separately charged television or phone access
- Any medically unnecessary private rooms
- More than 100 days of long-term nursing home care
- Hospital expenses incurred after your lifetime reserve days have run out
Even with all the helpful information on this page, we’re sure you probably have some additional questions. Hopefully, this FAQ section can answer those for you.
Is Medicare Part A free at age 65?
Only if you have a work history of 10 years (or 40 quarters), if you have a shorter work history, you will have to pay a monthly premium.
What is the Part A deductible for 2023?
The Medicare Part A deductible is $1,600. Remember that you only have to pay that deductible at the beginning of your benefit period when you get checked into a hospital as an inpatient. You don’t have to pay that deductible if you don’t require hospital care.
Can I just have Medicare Part A?
If you have to buy into Medicare Part A due to insufficient work history, you must also buy into Medicare Part B. Otherwise, you can delay enrolling in Medicare Parts A and B, but keep in mind that you could risk exposing yourself to financial penalties for late enrollment.
Can I opt out of Medicare Part A?
Yes, that’s an option – especially if you don’t have a sufficient work history to qualify for free Medicare Part A.
Who does not qualify for Medicare Part A?
Suppose you’re under 65 and don’t have a qualifying disability. In that case, you’ren’t eligible for Medicare Part A. Green cardholders who have lived in the US for less than five years will have to wait until they hit that threshold to apply for Medicare, even if they are already over the age of 65. If you have not worked at least 40 quarters in your lifetime in the US, you can qualify for Medicare Part A, but not premium-free Medicare Part A.
What is the benefit period for Part A?
The benefit period for Medicare Part A starts on the first day you’re checked into the hospital as an inpatient. The benefit period ends 60 consecutive days after the day you get checked out of the hospital. Remember that your Part A deductible is paid at the start of each new benefit period and not every year, meaning you may be required to pay your Part A deductible more than once in the same year if you’re unlucky.
Does Medicare Part A cover emergency room care?
Medicare Part A only covers emergency room expenses if you’re checked into the hospital as an inpatient. In every other scenario, Medicare Parts B, C, D, or Medigap will likely cover most of your expenses – but you could still face out-of-pocket costs.
How to Sign Up for Part A?
As we mentioned, any Medicare-eligible beneficiary receiving SSI benefits will be automatically enrolled and receive a card in the mail within three months of their 65th birthday.
Many situations force beneficiaries to enroll on their own. If you’re in that boat, visit your local Centers for Medicare & Medicaid Services office, call them, or fill out an application online.