Understanding Medicare Part A

Medicare Part A is one of the two main types (along with Part B) of medical insurance available for those over 65 or permanently disabled.

Medicare Part A covers:

Hospital Care Coverage

Inpatient care and all the expenses related to it can be quite stressful on your budget, especially if all you have is limited retirement savings. Medicare Part A covers hospital care coverage, which includes expenses for meals, semi-private rooms, nursing services, medications, and more. Whatever supplies or services you opt for at the hospital are also covered under Medicare Part A— to a reasonable degree—there are some exclusions.

Here is a complete list of inpatient care hospital expenses which are covered under the Medicare Part A:

• Mental health facilities
• Acute-care hospitals
• Long-term patient care hospitals
• Inpatient rehabilitation centers
• Verified participation in a clinical research study.
• Blood supplied by the hospital’s internal blood bank

As inclusive as the Medicare Part A insurance may seem, there are certain exceptions associated with its coverage, including expenses for the following:

• A private room (unless declared compulsory by medical experts)
• Private nursing
• Personal care items like trimmers, shampoos, etc.
• Those that are not medically necessary
• Extraneous entertainment and communication means such as TV and telephone
• Cost for purchasing blood from the external blood bank

Only the first three units of blood which you receive from an external blood bank will be free of charge. You will have to pay for the rest of the units or rely on supplementary insurance if you have any. This is easy to cover with Medigap Plan G or most of the other standard supplement plans.

On that note, there are insurance policies specifically designed to cover the above Medicare part A exclusions. These policies are called Medigap coverage and are offered by private insurance companies rather than the government.

Home Health Benefits

As a part of Medicare Part A, patients also receive a fair share of home health benefits.  For patients who can’t stay in hospitals for further treatment deemed necessary by the doctors, Medicare Part A covers the expenses of home health facilities. These services are often directed at patient recovery and bringing you back to voluntary lifestyle.

Here is what Medicare Part A can cover under home health benefits:

• Charges for intermitted or part-time nursing care and home health aide
• Expenses for physiotherapy
• Costs of speech-language pathology rehabilitation
• Expenses for occupational patient therapy
• Cost of medical equipment, specifically ordered by a medical expert, rented or purchased

There are, again, certain exceptions as to what Medicare Part A can cover under its home healthcare benefits. For starters, we have expenses for services which are irrelevant to your treatment. Other things not covered by this plan include:

• Meal expenses
• Costs for 24-hours home care services or live-in care providers
• Expenses on personal care items and services
• Charges for homemaker services

Nursing Home Coverage

Nursing home coverage is for patients who are seeking medical assistance even after getting discharged from a healthcare facility after being admitted as to inpatient care for a minimum of three days. Skilled nursing facilities are a major hospital service covered by Medicare Part A insurance. Patients kept for observation in outpatient wards are not eligible for receiving this coverage.

Medicare Part A covers the following primary skilled nursing facility services:

• Meal costs
• Semi-private room charges
• Expenses for skilled nursing services
• Cost of medical social services
• Cost of rehabilitation services
• Skilled nursing facility approved medical supplies and equipment
• Skilled nursing facility approved medications
• Ambulance expenses
• Charges for dietary counseling

You may be wondering regarding the eligibility of nursing Home coverage under Medicare Part A. Only those patients who require skilled care such as IV drug administration or physical therapy are eligible for getting this coverage.

It is also important to note that if you are seeking long-term personal or medical care, Medicare A will not cover it.

Hospice Coverage

Another fantastic benefit of Medicare Part A is that it offers a fair deal of hospice coverage. Hospice coverage refers to the medical care provided to the terminally ill patients who have less than six months to live. The ultimate goal of hospice care is to alleviate pain and make your remaining life as comfortable as possible.

Not all Medicare Part A recipients qualify for hospice coverage. To qualify, you must be:

• Enrollment in Medicare Part A
• Have a proven medical diagnosis of terminal illness (have less than six months to live)
• Consent to give up curative treatments and opt for palliative treatments
• Consent to receive hospice care from an approved facility

Eligibility

Medicare Part A is a systematic insurance plan for covering hospital care expenses for older patients. If you are a US Citizen and are 65 years old, you are eligible for Medicare Part A.

Some other situations which verify your eligibility for Medicare Part A include:

• Reception of retirement benefits
• Disabled and receiving disability benefits
• End-stage renal disease
• Amyotrophic Lateral Sclerosis or Lou Gehrig’s disease

The moment you turn 65, you are automatically enrolled in Medicare Part A if you are receiving Social Security Retirement Benefits. You will receive an information packet about three months before your 65^th birthday.

Other Medicare Programs

Medicare Part B – Coverage for outpatient and well patient services.

Medicare Part D – Prescription drug coverage

Medicare Supplement Plans – Private insurance designed to cover the gaps in traditional Medicare coverage.

Medicare Advantage (Part C) – A private insurance replacement for Parts A, B, D, and Supplements.

Enrolling in Medicare Part A

If you aren’t receiving social security, you’ll need to apply through the social security office. Enrollment in Medicare Part A is quite easy given that you match the eligibility criteria above. The two types of enrollment include a general method and a special method called SEP. You can directly enroll in the next available enrollment period if you have missed the previous one.

The duration of the general enrollment period is from the start of January to end of March every year.

To enroll in the special enrollment period,  you or your spouse must have lost employer insurance. Patients who have worked as volunteers in foreign countries can enroll for the SEP Medicare Part A immediately. The duration of this enrollment is eight months and starts from the next month after your employer coverage has ended.
Medicare Part A is free to any US citizen who has worked and paid taxes for at least ten years in their lifetime (40 quarters). If you haven’t met this requirement, there is a premium of up to $437 a month.