What is Medicare Part A?

Olivia Howard
Aug 26, 2017 · 3 min read
Source: Unsplash.com

Introduction

Medicare if often a confusing subject for people aging into their benefits for the first time. This article has been written to help you begin the process of understanding what Medicare is and what aspects of your health care needs are covered.

Medicare is divided into Parts A, B, C and D. In this article, we are going to begin to develop your understanding of Part A.

What is Medicare Part A?

Medicare Part A is your hospital insurance. The coverage includes inpatient care such as a semi-private room, bed and all your regular meals while you remain in hospital. Also included are nursing services, medications necessary for your inpatient treatment plus any other hospital supplies and services.

Some important Part A benefits include:

- Home health care services if considered medically necessary. This can include occasional skilled nursing care, speech and language services, medical social services as well as occupational and/or physical therapy.

- Care in a skilled nursing facility and nursing home care (providing custodial care is not your only care need). This can include a semi-private room, meals and dietary counselling, medication and medical supplies as well as rehabilitation and ambulance transportation services.

- Hospice care. Coverage exists if you are certified terminally ill with six months or less to live. Your coverage can include both doctor services and nursing care, pain relief medications, durable medical equipment and supplies as well as short term inpatient and respite care if needed for symptom and/or pain management.

Does Medicare Part A Cover all Hospital Services?

You will have noticed that Part A covers a semi-private room. That is because a private room will only be made available if it is deemed medically necessary. You are also not covered for private-duty nursing, personal care items and the cost of facilities such as televisions and telephones.

Your doctor may order durable medical equipment as part of your ongoing health care needs. This is covered separately under Medicare Part B which typically covers 80% of the cost. Personal services such as bathing and dressing are also not covered under Part A if this is the only care you need.

Sharing the Cost

You are responsible for your deductible before your Medicare coverage begins. Medicare will then cover costs for your first 60 days in hospital (or 20 days in a skilled nursing facility). From day 61 forward, you will pay a daily co-insurance which gets larger if you have a stay over 90 days.

After 90 days, you would enter your “lifetime reserve days”. All benefits cease at the end of your lifetime reserve days, or 150 days in the hospital, and you are subsequently responsible for all costs.

Next Steps

Medicare coverage is based upon federal and state laws. Coverage decisions focus on what services should be deemed medically necessary and covered at a national and local level. Always talk to your doctor or health care provider about your health care needs and Medicare coverage.

If you are relatively new to Medicare, it’s a good idea to do some reading about your benefits so that you will have a better idea of what’s covered and what isn’t.

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Creative writer, full-time freelancer and Entrepreneur.

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