Medicare Plan Part A (Hospital Insurance)

Medicare Plan Part A is hospital insurance provided by Medicare. Most people do not pay a premium for this coverage. Part A covers inpatient care in skilled nursing facilities, critical access hospitals, and hospitals. If you meet specific requirements, then you may also be eligible for hospice or home health care. It does not include long-term or custodial care. Private insurance companies are the intermediaries that process and pay Medicare claims for the federal government.

Whatever health care insurance coverage you choose, make sure you have a clear understanding of all the options, coverage and premiums. Don't be afraid to ask questions and seek a Medicare representative that can help you to fully understand and tell you what you will need to do to sign up.

Medicare Part A Helps Pay For:

Care in hospitals as an inpatient, critical access hospitals (small facilities that give limited outpatient and inpatient services to people in rural areas), skilled nursing facilities (not custodial or long-term care), hospice care, and some home health care. Information about your coverage under Medicare Part A can be found in the Medical Coverage database.  If you aren't sure if you have Part A, look on your red, white, and blue Medicare card. If you have Part A, "HOSPITAL (PART A)" is printed on your card.

Specifically, Medicare Part A covers blood transfusions that you receive during your hospital stay in a hospital or a skilled nursing facility.

Regarding hospital stays, Part A will cover a semi-private room, general nursing care, meals and regular hospital supplies and services. Also covered is inpatient critical access hospital and mental health care. Stays in the hospitals must be at least 3 days (72 hours).

Any nursing home or skilled nursing facility care must be related to your diagonsis during your stay at the hospital. If your hospital stay was for a heart attack, then your nursing facility stay for rehabilitation would be covered. Your stay at the nursing facility is similar to the hospital with a semi-private room, meals and nursing care being covered.

Coverage for Part A is limited to 100 days maximum during a benefit period. Your first 20 days are paid in full and the remaining 80 days are a co-payment. Medicare A does not cover daily living, long-term care, or non-skilled nursing care.

Part A does help cover Hospice care, which is for a person that is terminally ill and only has six months to live. The coverage for Hospice includes medical services, grief counseling, pain relief and associated drugs. Care is given by a Medicare-approved caregiver that visits you at your home. Medicare will also cover any additional care for a Hospice patient so that the main caregiver can take some time off. Medicare does not cover all the services that may be provided by Hospice.

Medicare Part A only covers limited home health care services and part-time care. Some of the services that are covered are skilled nursing care, therapy, speech language pathology, home health aid service and medical social services. Part A will also cover some specific equipment for use at home. These include hospital beds, wheelchairs, walkers and oxygen.

Cost of Medicare Part A:

You typically get Medicare Part A automatically when you turn age 65. You don't have to pay a monthly payment called a premium for Part A because you or your spouse paid Medicare taxes while you were working throughout your career.  If you don't automatically get premium-free Part A, you may be able to buy it if you (or your spouse) aren't entitled to Social Security because you didn't work or didn't pay enough Medicare taxes while you worked and you are age 65 or older, or you are disabled but no longer get premium-free Part A because you returned to work.  If you have limited income and resources, your state of residence may help you pay for Medicare Part A and/or Medicare Part B.