What Does Medicare Part A Cover?

What Does Medicare Part A Cover?
Medicare

Original Medicare health care insurance is divided into two sections, Medicare Part A is the hospital insurance, and Part B is medical insurance. You become eligible for Medicare coverage when you reach 65. If you are not earning pension payments from either Social Security or the Railroad Retirement Board when you turn 65, you are automatically enrolled in all sections of Medicare through these administrations.

If you are younger than 65, but have a qualified disability and are granted coverage for 24 months, or have end-stage renal disease, or ALS, you will also be automatically enrolled in Medicare. You are eligible for premium-free Part A Medicare if you or your spouse have operated and paid Medicare taxes for at least 40 quarters (10 years).


Here's a detailed look at what's covered by Medicare Part A:

Trained treatment for nursing homes

Medicare hospital insurance (Part A) provides short-term treatment in a licensed nursing facility if you have days left in your current coverage span, have been in the hospital and need more qualified nursing care to get better, or for a special reason, the doctor recommends this care. Also, Medicare must certify the facility.

Hospital for long-term treatment

For up to 60 days after you pay the premium for the current benefit duration, Part A covers the cost of long-term care in a Medicare-approved facility. You pay the costs that are valid after 60 days.

Inpatient treatment at a hospital

In a hospital that accepts Medicare, Part A pays for inpatient services if the doctor certifies that you need this care for the treatment of an accident or disease. Your coverage, when you are in the hospital, includes:

  •  A semi-private space and your meals
  • General treatment in nursing
  • Any medications that you need in the hospital for your care
  • Any other facilities and equipment at the hospital that you get

You also get coverage under Medicare Part A, in:

  • Hospitals with acute treatment and critical access
  • Inpatient rehabilitation and mental hospitals
  • Hospitals providing long term treatment
  • If you are in a qualifying clinical research review, inpatient treatment

Medicare Part C

Hospice Care

When you comply with any of the following requirements, Medicare Part A covers your hospice care:

  • Both your family doctor and hospice physician certify that you are terminally ill.
  • Instead of medication for sickness, you prefer palliative care and commit to hospice care in place of other Medicare-covered benefits for your disease treatment.

When you are in hospice care, and the following care and facilities are also included in your Medicare benefits based on the treatment plan the hospice team has made:

  • Therapies for physical, occupational and speech-language
  • Social work services
  • Dietary counseling 
  • Some programs for you and your family for counseling
  • Short-term emergency treatment
  • Other programs provided by Medicare
  • Physician Services
  • Nursing Care
  • Medical instruments and supplies
  • Prescription medicine
  • Hospice aide and service for homemakers

Home Health Services

If you're eligible, the Medicare Part A benefits will cover 100 percent of the cost of some home health services. You pay 20 percent of the Medicare-approved cost for this equipment if you need reliable medical equipment. The facilities that are provided by your hospital benefits include:

  • Professional nursing services part-time or sporadic
  • Physical or occupational counseling
  • Speech-language programs for pathology
  • Social medical programs
  • On a part-time or occasional basis, home health aide programs
  • Injectable osteoporosis medications for qualified women

You may not qualify for the home health option if you require more than part-time or intermittent care, but you can leave home for short-term medical treatment or adult daycare and still be qualified.


How your Medicare Part A coverage is affected by Medicare Advantage

You would have at least the same coverage as Original Medicare Part A and Medicare Part B if you want to enroll in a Medicare Advantage plan, although there are different advantages to most Medicare Advantage plans. Check out the Medicare Advantage plans in your region if you are going to apply for Medicare soon, or want to explore your options.

You can compare Medicare plans. For little or no extra cost, you can find that you can get access to more benefits.
 

Compare Medicare Plans

 


Related Articles:

Guide: Medicare Advantage 101

What's the Difference between Medicare and Medicaid?

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