Medicare Part A
What is Medicare Part A?
Medicare Part A is your hospital insurance for all your inpatient care services. The use of these benefits will likely take place in a hospital; however, coverage also extends to senior care centers and nursing facilities. You can think of this first part of Medicare as your room and board if you were to need intensive care. It even covers your meals during inpatient stays.
What Does Medicare Part A Cover?
- Inpatient care in a hospital
- Skilled nursing facility care
- Inpatient care in a skilled nursing facility (not custodial or long-term care)
- Hospice care
- Home health care
What Part A Doesn’t Cover
Part A does not cover any outpatient care services.
Office visits, lab testing, preventative services, simple surgeries, ambulance rides, dialysis, chemotherapy, and other outpatient care services are covered under Medicare Part B.
Inpatient Care vs. Outpatient Care
Inpatient care: admission into a hospital or treatment facility for more than 24 hours.
Outpatient care: receiving medical care without being admitted and stay for less than 24 hours.
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How Much Does Medicare Part A Cost?
Most Medicare beneficiaries receive their Part A benefits for free. As long as you have worked 40 quarters (10 years) in which you paid Medicare taxes, your Part A premium is free.
Individuals with less than 40 working quarters will pay a monthly premium for Medicare benefits. The premium will be in proportion to the percentage you have paid into Medicare.
If you were to buy the same insurance coverage on the open market, it would cost over $400 per month.
Out Of Pocket Expenses
Though your premiums are likely free, there are still out of pocket costs to be aware of.
Part A has strict limits for both hospital stays, and Nursing Facility stays. And it does not provide long term care coverage.
Skilled Nursing Facility Stays
Medicare covers up to 20 days in a skilled nursing facility. If your stay goes past 20 days, you will pay a daily co-payment of $170.50 for days 21-100.
After 100 days, your benefits are used up, and you will pay the full amount of cost.
Inpatient Hospital Stays
The Part A deductible in 2020 is $1,408 for each benefit period. After you reach your deductible, Medicare covers up to 150 days in the following amounts:
- Days 1-60: $0
- Days 61-90: $352 coinsurance per day
- Days 91-150: $704 coinsurance per day
- Beyond 150 days: all cost
Extending Your Medicare Part A Benefits
Inpatient medical stays are expensive. Your Part A benefits will undoubtedly help if you need intensive care. However, as shown in the numbers above, costly medical bills await anyone who needs extended care beyond that which Medicare covers.
Fortunately, there are several options for you to customize and extend your benefits. Let’s take a look.
Medicare Supplemental Insurance: These private health insurance plans fill in the financial gaps existing in Original Medicare, such as co-pays, coinsurance, and deductibles. Medicare Supplements also extend your benefits for 365 days of inpatient care.
Medicare Advantage: These are an all in one solution for health care needs. Medicare advantage bundles your Original Medicare benefits with additional covered services to provide more robust and complete coverage. They also extend your inpatient care up to 365 days and provides additional coverage for vision, dental, and prescription drugs.
Long Term Care Insurance: As mentioned above, Medicare part A provides short term coverage for inpatient medical care. With a traditional long term care insurance policy, you can extend your coverage for multiple years.
When To Enroll
The Medicare Enrollment Period is a seven-month window beginning three months before your 65th birthday, includes your birthday month, and continues for the following three months. Anyone who has begun taking Social Security benefits is automatically enrolled in Medicare.
Your Medicare card will arrive in the mail 60 to 90 days before your 65th birthday. The card is red, white, and blue. It is also laminated so you will only have to request a replacement card if you were to lose it.
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