Medicare Part A Explained

One part of the Medicare program is called Medicare Part A. Most people do not have to pay a premium for Medicare Part A because the individual paid Medicare taxes while working.

What is Medicare Part A?

Medicare Part A is a type of hospital insurance provided by Medicare. The coverage provided by Medicare Part A includes inpatient care in hospitals, nursing homes, skilled nursing facilities, and critical access hospitals. Medicare Part A does not include long-term or custodial care.

Private insurance companies handle the claims for the Medicare Part A plan that act as agents for the federal government in processing and paying Medicare claims.

What does Medicare Part A Cover?

Medicare does not cover everything, nor does it cover the total cost for many of the covered services or medical supplies. Coverage amounts are based on which Medicare plan you have. Medicare Part A helps cover only the medically necessary services below:

Blood Transfusions

This is blood that you receive during a covered stay in a hospital, critical access hospital, or a skilled nursing facility.

Hospital Stays

Medicare Part A covers hospital stays, which includes a semi-private room, meals, general nursing, and some hospital services and supplies. Inpatient care in critical access hospitals and mental health care are also covered. Hospital stays must be at least 3 days. The time begins the first midnight after admission and does not include any hours on the discharge date.

Nursing Home or Skilled Nursing Facility

Nursing home or skilled nursing facility stays must be related to diagnosis during a hospital stay. A nursing home or skilled nursing facility stay includes a semi-private room, meals, and rehabilitative and skilled nursing services and care.

The coverage is limited to a maximum of 100 days in a benefit period. The first 20 days are paid in full, and the remaining 80 days will require a co-payment. Medicare Part A will not cover long-term care, non-skilled, daily living, or custodial activities.

Home Health Services

Home health services include medically necessary part-time care and services including skilled nursing care, physical or occupational therapy, home health aide service, and medical social services. It also includes certain home-use medical equipment and other medical supplies.

Hospice Care

Hospice care is for the terminally ill who have six months or less to live. Coverage includes pain relief and symptom control drugs, medical and support services, grief counseling, and other services. Care is provided by a nearby, Medicare-approved Hospice caregiver who will visit you at your home. Medicare does not cover many of the services that are provided to patients who receive Hospice assistance.

Whatever health care and Medicare insurance coverage you choose, make sure you have a clear understanding of all the Medicare options, Medicare coverage and Medicare premiums.