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 to know 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 the medical care you get 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, but every Medicare beneficiaries circumstances are different and you may have to buy into this coverage if you have an insufficient work history.
How Much is Medicare Part A?
If you have a work history that is at least 10 years (or 40 quarters) long, then 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 work history will pay $499 per month for Part A. For those beneficiaries with at least 30 quarters, the monthly premium is $274.
Who’s Eligible for Part A?
If you are about ready to turn 65 years of age and you are currently receiving Social Security benefits, then you will be automatically enrolled and you should receive all of your important documents in the mail.
They should arrive within three months before your 65th birthday. If you do not receive your documents, contact your local CMS office.
People under the age of 65 who have a serious medical illness, such as End-Stage Renal Disease, are likely eligible for Medicare Part A. Contact your local CMS Office for more information.
If you’re not currently receiving Social Security benefits, you will have to enroll on your own. Even if you are still 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?
Obviously, 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 you’re not checked in as an inpatient.
Therefore, Part A does not cover your care. But as long as you are admitted, 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 of 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 2022?
The Medicare Part A deductible is $1,556. Keep in mind 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 do not 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 both Medicare Parts A and B, but keep in mind you could risk exposing yourself to financial penalties for late enrollment.
Can I opt-out of Medicare Part A?
Yes, that is 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?
If you are under the age of 65 and do not have a qualifying disability, you are not eligible for Medicare Part A. Green cardholders who have lived in the US for less than 5 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 are checked into the hospital as an inpatient. The benefit period ends 60 consecutive days after the day you get checked out of the hospital. Keep in mind your Medicare Part A deductible is paid at the start of each new benefit period, and not on a yearly basis. This means you may be required to pay your Part A deductible more than once in the same year if you are unlucky.
Does Medicare Part A cover emergency room care?
Medicare Part A only covers emergency room expenses if you end up being checked into the hospital as an inpatient. In every other scenario, Medicare Parts B, C, D, or Medigap will most likely cover the majority of your expenses – but you could still face some out-of-pocket costs.
How to Sign Up for Part A?
As we mentioned earlier, any Medicare-eligible beneficiary who is currently receiving SSI benefits will be automatically enrolled and receive a card in the mail within three months of their 65th birthday.
There are many situations that force beneficiaries to enroll on their own. If you’re in that boat, be sure to visit your local CMS office, call them, or fill out an application online.
Once you enroll in Part A & Part B and are ready to enroll in a supplemental Medicare plan, give us a call. Or, you can complete our rate form here.