Medicare Part A
Medicare Part A is one of four parts of Medicare and provides hospital coverage.
It is free for the vast majority of individuals, though most people have paid for it through taxes over the years.
Medicare Part A and Medicare Part B make up what is called Original Medicare. Medicare Part A includes hospitalization and accompanying services, and Medicare Part B covers doctors’ services.
What is Medicare Part A?
Medicare Part A is a health insurance program offered by the federal government to United States citizens who are 65 and older or those with certain disabilities. It is one of the core components of Medicare, along with Part B, Part C, and Part D.
Part A covers hospitalization costs such as inpatient care in skilled nursing facilities as well as home healthcare services for people eligible for Medicare.
This includes hospital stays for an illness, injury or surgery, hospice care for those facing terminal illnesses, limited skilled nursing facility care following a hospital stay, and home health services such as physical therapy and speech-language pathology.
It also includes some preventive services like flu shots and screening mammograms that can help you stay healthy.
Part A is a premium-free entitlement benefit if you or your spouse has paid into the Social Security system for at least 10 years.
If you do not qualify for a premium-free policy due to a lack of work history but would still like to purchase coverage under Part A, you can purchase it by paying premiums on a monthly basis.
Part A covers up to 90 days of inpatient hospital care per benefit period. Coverage can include 60 days of inpatient skilled nursing facility care following a three-day hospital stay within that same period.
Home health services may be covered up to seven days per week if needed and may include physical therapy, occupational therapy, and other medical-social services.
It’s important to note that Part A does not cover all types of care like dental work or vision exams unless it’s related to another illness covered by Medicare (such as jaw problems caused by diabetes). Prescription drugs are also not included under Part A; these are usually taken care of through private insurance plans or Medicare Advantage plans (which are offered through private companies).
Part A is an important part of overall healthcare coverage because it provides protection against large medical expenses that could arise due to unforeseen health problems such as unexpected hospital stays or long-term home health needs.
It also offers extra coverage beyond what most private health insurance plans provide so it’s important to understand what benefits you receive under this program before making any decisions about purchasing additional medical coverage.
What does Medicare Part A Cover?
Medicare Part A is a health insurance program that covers a range of medical services for those who are eligible.
It is designed to help reduce the financial burden of hospitalizations and other medical treatments, as well as provide coverage for long-term care.
Medicare Part A provides coverage for:
- hospital stays
- home health care
- hospice care
- skilled nursing facility visits
- some preventive services
Medicare Part A covers most inpatient hospital stays up to 90 days, including meals while you’re in the hospital and semi-private rooms. It also pays the doctor’s fees related to your hospital stays, such as lab tests or surgery.
Home Health Care:
Medicare Part A also covers medically necessary home health care services provided by skilled professionals when you can’t leave your home due to illness or injury.
This includes physical therapy, occupational therapy, speech-language pathology services, social service services, and medical supplies related to your treatment.
Hospice Care: Medicare Part A covers hospice care for people with terminal illnesses if certain conditions are met.
This typically includes doctor visits, nursing care, and medical equipment such as wheelchairs or walkers. It may also cover medications related to pain relief or symptom management when they are prescribed by a doctor enrolled in Medicare.
Skilled Nursing Facility Visits:
If you need more extensive recovery time than can be provided at home after a hospital stay, Medicare Part A will cover short-term (up to 100 days) skilled nursing facility visits following a three-day inpatient admission.
This coverage includes all medically necessary rehabilitation services such as physical therapy or speech-language pathology services that may be needed during your stay.
Finally, Medicare Part A covers certain preventive services that can help improve your overall health and well-being such as flu shots and screenings for breast cancer or colorectal cancer.
Other preventive benefits include one “Welcome to Medicare” physical exam within 12 months of enrollment and an annual wellness visit each year after that (if you haven’t had another type of visit within the last year).
Medicare Part A Cost
For most people, the cost of Medicare Part A is free. This is because they have already paid into the Medicare system through payroll taxes during their working years.
For those who have not been employed long enough to qualify for premium-free Part A coverage, the monthly premium will depend on how many years they have worked and paid into the Medicare system. Generally speaking, the longer a person has worked and contributed to Medicare payroll taxes, the lower their monthly premiums will be.
For those with fewer than 30 quarters paying into payroll taxes (or 7 ½ years), there is a premium charged for each month that they are enrolled in Part A coverage.
People who are not eligible for premium-free Part A may still qualify for reduced or subsidized premiums if they meet certain income qualifications. Eligibility requirements vary based on the state but generally include individuals who qualify for government programs such as Supplemental Security Income (SSI) or Medicaid.
Additionally, people who meet annual income limits may also be eligible for reduced premiums or subsidies on their Part A costs if they purchase a qualified health plan through one of the Health Insurance Marketplaces created under the Affordable Care Act.
In addition to monthly premiums, there may also be other costs associated with Medicare Part A coverage including deductibles and out-of-pocket maximums that must be met before full benefits are available.
Deductibles refer to an amount that must be paid upfront before any coverage begins; this amount varies depending on the length of stay and type of service received but may range from several hundred dollars per day up to more than $1,000 per day in some cases.
Medicare Part A Deductible 2023
The Medicare Part A deductible is a set amount that must be paid each year before Medicare will begin to pay for medical costs.
The current Medicare Part A deductible for 2023 is $1,600 per benefit period and increases each year according to the Consumer Price Index (CPI). Each benefit period begins the day you enter the hospital and ends when you have been out of the hospital or a skilled nursing facility for 60 days in a row.
If you need additional hospital stays during the same benefit period, you will not have to pay another deductible.
In addition to covering your inpatient medical costs, Medicare Part A also helps cover some costs related to short-term stays at skilled nursing facilities as well as hospice care and home health care services.
However, there are eligibility requirements for these benefits; for instance, you must have been admitted to a hospital for at least three days before being eligible for coverage at a skilled nursing facility or hospice.
Many people opt to purchase supplemental insurance policies that help cover additional expenses related to these services such as copayments or coinsurance not covered by Medicare Part A.
It’s important to note that even after your Part A deductible has been met, you may still be responsible for some out-of-pocket expenses such as copayments or coinsurance amounts when receiving certain services at hospitals and other medical facilities.
Also, be aware that some types of medical services may not be covered under Part A—such as cosmetic surgery or long-term care—so it’s best to review your policy carefully so that you understand what is covered and what additional expense may apply should you require such services.
Updated December 4th, 2022