Medicare Part A – Definition & Detailed Explanation – Elderly Legal and Financial Planning Glossary

What is Medicare Part A?

Medicare Part A is a component of the federal health insurance program in the United States that provides coverage for inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care services. It is often referred to as hospital insurance and is one of the four parts of Medicare, along with Part B, Part C, and Part D.

Who is eligible for Medicare Part A?

Most individuals who are 65 years or older are eligible for Medicare Part A if they or their spouse have worked and paid Medicare taxes for at least 10 years. People under 65 with certain disabilities or medical conditions may also qualify for Medicare Part A. Additionally, individuals of any age with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS) are eligible for Medicare Part A.

What does Medicare Part A cover?

Medicare Part A covers a range of services related to inpatient care, including hospital stays, skilled nursing facility care, hospice care, and some home health care services. This includes services such as inpatient hospital care, skilled nursing facility care, hospice care, and home health care services. Medicare Part A also covers some blood transfusions, durable medical equipment, and certain prescription drugs administered during an inpatient stay.

How does Medicare Part A work with other insurance?

Medicare Part A can work with other types of insurance coverage, such as employer-sponsored health insurance or Medicaid. In most cases, Medicare Part A is the primary payer for covered services, and other insurance may act as a secondary payer. It is important to coordinate coverage with other insurance plans to ensure that all services are covered and that costs are minimized.

What are the costs associated with Medicare Part A?

Most individuals do not have to pay a premium for Medicare Part A if they or their spouse have paid Medicare taxes while working. However, there are costs associated with Medicare Part A, including deductibles, coinsurance, and copayments for certain services. For example, in 2021, the deductible for a hospital stay under Medicare Part A is $1,484 per benefit period, and there may be coinsurance costs for extended hospital stays.

How to enroll in Medicare Part A?

Individuals who are eligible for Medicare Part A are typically enrolled automatically when they turn 65 and are receiving Social Security or Railroad Retirement Board benefits. If you are not automatically enrolled, you can sign up for Medicare Part A during your initial enrollment period, which begins three months before your 65th birthday and ends three months after. You can enroll in Medicare Part A online, by phone, or in person at a Social Security office.