There are around 44 million people currently enrolled in Medicare. That’s around fifteen percent of the entire US population. In ten years, that number is expected to rise to 79 million beneficiaries.
There are several different parts to Medicare and it can be confusing to remember what each part does. One of the most popular parts of Medicare is Medicare Part A. 
Medicare Part A (hospital insurance) is one-half of Original Medicare. The other half of Original Medicare consists of Medicare Part B (medical insurance).
Medicare inpatient care is covered by Medicare Part A. That includes care that a patient receives while in a skilled nursing facility, a hospital, and in some instances, at home.
If you’re interested in learning more, then continue reading and we’ll go over what Medicare does and does not cover and also how enrollment and eligibility work.
Eligibility for Medicare Part A
Generally speaking, there are a few conditions that you have to meet in order to be eligible for Medicare Part A. First, you must be at least 65 years old.
You should also already be collecting retirement benefits from the Social Security Administration. You can also be eligible for Medicare Part A if you’re disabled and you’re receiving disability benefits. You can also qualify for Medicare before you turn 65 if you have amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD).
The majority of Medicare Part A beneficiaries don’t have to pay a premium as long as they worked for at least forty quarters (or ten years) and paid Medicare taxes during that time. If you’re not eligible for the premium-free version of Medicare Part A, you can still enroll as long as you pay a premium.
A person who delays their enrollment after their initial enrollment period for Medicare Part A might have to pay a late enrollment fee after they sign up.
Initial Enrollment in Medicare Part A
If you’re already collecting retirement benefits by the time you turn 65, you’ll likely be automatically enrolled in Medicare Part A. The benefits of Medicare Part A start on the first day of the month that you turn 65. If you were born on the first of the month, then your benefits will start the month before you turn 65.
If you don’t qualify for Social Security benefits, then you’ll have to enroll manually in Medicare Part A during the IEP (Initial Enrollment Period). This period starts three months before you turn 65 years old and it ends three months after your 65th birthday.
If you don’t enroll during the Initial Enrollment Period, you’ll have to wait until the new year to enroll in the next general enrollment period. You also might have to pay a late-enrollment penalty when you sign up after your IEP.
Medicare Part A Hospital Care Coverage
As a beneficiary of Medicare Part A, you’ll get coverage for hospital costs that are necessary to your inpatient care. This includes coverage for medications, nursing services, meals, and a semi-private room. This can include inpatient care that you get through:
- Mental health care
- Long-term care hospitals
- Inpatient rehabilitation facilities
- Critical access hospitals
It’s important to point out that Medicare Part A doesn’t cover the costs for personal care items like toiletries, private-duty nursing, a private room, or other charges like television and telephone.
Medicare Part A also won’t cover the cost of blood. If the hospital gets its blood donated from a blood bank, then you won’t have to pay anything. But if the hospital has to buy blood for you, then you’ll have to cover the cost of the first three units that you’re given.
Medicare Part A Nursing Home Coverage
Medicare Part A covers skilled nursing facility (SNF) stays that take place after a qualifying hospital inpatient stay. To qualify for this kind of care, a patient must stay in a hospital for at least three days.
The skilled nursing care needs to take place at a facility that has been certified by Medicare. Skilled nursing care that’s covered by Medicare includes:
- Dietary counseling
- Medical equipment and supplies
- Medications received while in SNF care
- Medical social services
- Rehabilitation services
- Meals
- Semi-private room
Your doctor will have to certify that you need daily skilled care that you can’t get at home. Long-term and personal care are not covered by Medicare Part A.
Medicare Part A Hospice Coverage
If you have a terminal illness with an estimated six months or less to live, then you might qualify for hospice care coverage. Hospice coverage focuses on palliative care rather than on curing your illness. The aim is to relieve pain and make the patient as comfortable as possible.
In order to receive hospice care coverage from Medicare Part A, you must:
- Receive hospice care from a facility that’s Medicare-approved
- Agree to give up curative treatments for your terminal illness
- Be enrolled in Medicare Part A.
- Have been certified with a terminal illness and have six months or less to live
You should know that you also have the ability to stop hospice care at any time if you’d like to focus on curative treatments.
The Importance of Knowing About Medicare Part A
If you’re nearing your Initial Enrollment Period and want to know what’s going to happen to your health insurance, then it’s important that you understand what Medicare Part A is and how it works. Because of all of the various Medicare Parts, plans, and supplements, it can be difficult to know which plan is best for you.
If you have any questions or concerns about a specific Medicare plan, then contact us today and see how our expert staff can help you!
