{"id":55826,"date":"2022-12-14T14:32:31","date_gmt":"2022-12-14T19:32:31","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=55826"},"modified":"2024-10-25T11:00:51","modified_gmt":"2024-10-25T15:00:51","slug":"what-is-medicare-part-a","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/what-is-medicare-part-a\/","title":{"rendered":"What is Medicare Part A?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\"><\/span><\/p>\n<p><span style=\"font-weight: 400;\">Medicare was signed into law by Lyndon B Johnson in 1965 and <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medicare\/\"><span style=\"font-weight: 400;\">has four parts<\/span><\/a><span style=\"font-weight: 400;\">. This article will focus on Medicare Part A, which covers inpatient hospital stays, among several other services, such as subacute rehabilitation in a skilled nursing facility.<\/span><\/p>\n<h2 id=\"what-does-medicare-part-a-cover\"><span style=\"font-weight: 400;\">What does <\/span><span style=\"font-weight: 400;\">Medicare Part A cover<\/span><span style=\"font-weight: 400;\">?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">When it comes to inpatient services or hospital insurance for people with Medicare, Medicare Part A provides that coverage. You&#8217;ll be required to meet a deductible when admitted to the hospital. This deductible isn&#8217;t just paid once a year, and it&#8217;s reoccurring with each benefit period. Anytime you are admitted as an inpatient in a new benefit period, you&#8217;ll have to pay it.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A benefit period begins the first day you are admitted to an inpatient facility and concludes when you have not received inpatient care for 60 days in a row. If you are admitted to the hospital after a benefit period has concluded, a new benefit period will begin when you are admitted, and the deductible must be paid again.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Once you pay your Medicare Part A deductible, there is $0 coinsurance for the first 60 days in the hospital. If your inpatient hospital stay is longer than 60 days, you&#8217;ll pay an additional copay for each day.<\/span><\/p>\n<h3 id=\"whats-not-covered\"><span style=\"font-weight: 400;\">What&rsquo;s not covered<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Medicare doesn&#8217;t cover the costs of long-term care facilities such as a nursing home, including if you&#8217;re in hospice.&nbsp;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Outpatient services such as visits to your healthcare provider, outpatient surgery, and laboratory tests are not covered under your Hospital coverage. These services are covered under Medicare Part B.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Part B covers outpatient care such as doctor visits, preventive services, durable medical equipment, and diagnostic health screenings. For more information on Medicare Part A costs and qualifications, visit<\/span><a href=\"https:\/\/www.medicare.gov\/basics\/costs\/medicare-costs\" target=\"_blank\" rel=\"noopener\"> <span style=\"font-weight: 400;\">medicare.gov<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<h2 id=\"who-is-eligible-for-medicare-part-a\"><span style=\"font-weight: 400;\">Who is eligible for <\/span><span style=\"font-weight: 400;\">Medicare Part A<\/span><span style=\"font-weight: 400;\">?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Original Medicare includes Medicare Part A and Part B, which share the same eligibility requirements.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Medicare Part A eligibility criteria:&nbsp;<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Aged 65 or older<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Or under 65 with specific health conditions<\/span>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">End-Stage Renal Disease<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><a href=\"https:\/\/www.singlecare.com\/conditions\/als-treatment-and-medications\"><span style=\"font-weight: 400;\">Lou Gehrig&#8217;s disease<\/span><\/a><span style=\"font-weight: 400;\"> (Amyotrophic Lateral Sclerosis)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Receiving disability benefits for more than 24 months<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Be a resident of the United States<\/span>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Either as a U.S. Citizen<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Or a legal alien admitted for permanent residence. You must live in the U.S. for a continuous five years before applying.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2 id=\"how-much-does-medicare-part-a-cost\"><span style=\"font-weight: 400;\">How much does <\/span><span style=\"font-weight: 400;\">Medicare Part A cost<\/span><span style=\"font-weight: 400;\">?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Most Medicare beneficiaries qualify for premium-free Part A. Part A is paid through your Medicare taxes while you&#8217;re working. To qualify for the premium-free Part A, you must work and pay your Medicare taxes for at least 40 quarters, which is equivalent to 10 years, qualify with a spouse&rsquo;s work history, or have Railroad Retirement Benefits.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you have not worked and paid the Medicare tax for at least 40 quarters, you may still enroll in Medicare Part A, but you may have a monthly premium.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you or your spouse worked between 30 and 39 quarters, you&#8217;d pay $278 per month for Medicare Part A. If you or your spouse work less than 30 quarters, you&#8217;ll pay $505 per month for Medicare hospital insurance.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Many beneficiaries who have to pay a Part A premium will have it deducted from their monthly Social Security benefit. However, you may pay directly if you choose to do so or if you have not yet started collecting Social Security.&nbsp;<\/span><\/p>\n<h2 id=\"medicare-part-a-enrollment\"><span style=\"font-weight: 400;\">Medicare Part A enrollment<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Medicare Part A enrollment can be automatic, but some people may need to apply. It will depend on your situation. Suppose you&#8217;re already receiving Social Security or Railroad Retirement benefits as you turn 65. In this case, you&#8217;ll be automatically enrolled if you meet the eligibility requirements.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Consequently, if you are diagnosed with ALS or have been on disability for more than 24 months, you&#8217;ll automatically be enrolled in Medicare.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You&#8217;ll need to apply for Medicare if you&#8217;re not collecting Social Security or Railroad Retirement benefits. If you have <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/chronic-kidney-disease\/\"><span style=\"font-weight: 400;\">ESRD<\/span><\/a><span style=\"font-weight: 400;\">, you will not be automatically enrolled, but you will qualify if you are under 65. In this case, you&#8217;ll need to apply for Medicare.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You may enroll in Medicare at specific times (enrollment periods). If you choose to enroll after your Initial Enrollment Period and don&#8217;t have creditable coverage, you could be subject to a Medicare late enrollment penalty. There are different late enrollment penalties for Part A, Part B, and Part D of Medicare.<\/span><\/p>\n<h3 id=\"initial-enrollment-period\"><span style=\"font-weight: 400;\">Initial Enrollment Period<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Three months prior to your 65th birthday or if you are diagnosed with a qualifying health condition, you start your Initial Enrollment Period. The Initial Enrollment Period is a 7-month window to apply for Original Medicare.<\/span><\/p>\n<h3 id=\"special-enrollment-period\"><span style=\"font-weight: 400;\">Special Enrollment Period<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Suppose you&#8217;re leaving or losing creditable coverage such as a group employer plan. In that case, you&#8217;ll have eight months from the date the plan ends to enroll in Medicare. This enrollment period is known as a Special Enrollment Period. There are many <\/span><a href=\"https:\/\/www.medicare.gov\/sign-up-change-plans\/joining-a-health-or-drug-plan\/special-circumstances-special-enrollment-periods\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">scenarios<\/span><\/a><span style=\"font-weight: 400;\"> that could make you eligible for a SEP.<\/span><\/p>\n<h3 id=\"general-enrollment-period\"><span style=\"font-weight: 400;\">General Enrollment Period<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If you miss your Initial and Special Enrollment Periods, you&#8217;ll be required to wait until the <\/span><a href=\"https:\/\/www.medicare.gov\/basics\/get-started-with-medicare\/sign-up\/when-does-medicare-coverage-start\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">General Enrollment Period<\/span><\/a><span style=\"font-weight: 400;\">. This enrollment period begins on January 1 and ends on March 31. You can enroll in Medicare during this time, but the coverage won&#8217;t start until the first day of the following month after you sign up.<\/span><\/p>\n<h2 id=\"how-to-save-money-on-medicare-part-a\"><span style=\"font-weight: 400;\">How to save money on <\/span><span style=\"font-weight: 400;\">Medicare Part A<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There are costs associated with Medicare Part A, which can get out of control fast. You can do a few things to protect yourself from the high costs associated with Medicare Part A and Part B.<\/span><\/p>\n<h3 id=\"1-medicare-advantage-part-c\"><span style=\"font-weight: 400;\">1. Medicare Advantage (Part C)<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">You can choose to receive your Medicare coverage through a <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medicare-advantage\/\"><span style=\"font-weight: 400;\">Medicare Part C plan<\/span><\/a><span style=\"font-weight: 400;\">. These Medicare Advantage plans will combine your inpatient care and outpatient medical insurance from Original Medicare into one plan. In addition, these plans will usually include your <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-part-d-vs-medicare-advantage\/\"><span style=\"font-weight: 400;\">Medicare Part D prescription drug coverage<\/span><\/a><span style=\"font-weight: 400;\"> and sometimes additional benefits that Original Medicare doesn&#8217;t include, like vision and dental coverage.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Most Medicare Advantage plans are network-based. This means that if you use providers that aren&#8217;t in the network, you&#8217;ll be responsible for a higher copay or potentially the entire cost. Most Medicare Advantage Prescription Drug (MAPD) plans will also need referrals and authorizations for specialists and services before they are covered.<\/span><\/p>\n<h3 id=\"2-medicare-supplement-insurance\"><span style=\"font-weight: 400;\">2. Medicare Supplement Insurance&nbsp;<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Another option to save is to add a Medicare Supplement health insurance program (Medigap plan) to your Original Medicare plan. Medigap plans help cover the costs left over from coverage of your Part A coverage and Part B health services. These plans don&#8217;t include your prescriptions, so you&#8217;ll need to add a prescription drug plan<\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medigap\/\"><span style=\"font-weight: 400;\">Medigap plans<\/span><\/a><span style=\"font-weight: 400;\"> are designed to cover your Medicare costs for all covered services related to Medicare Parts A and B. Medicare Supplement Insurance plans are health plans provided by private insurance companies. Unlike Medicare Advantage plans, these plans aren&#8217;t network-based and don&#8217;t require referrals or additional approvals.<\/span><\/p>\n<h3 id=\"3-medicaid\"><span style=\"font-weight: 400;\">3. Medicaid&nbsp;<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If a Medicare beneficiary is low-income, they may <\/span><a href=\"https:\/\/www.medicaid.gov\/medicaid\/eligibility\/index.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">qualify for Medicaid<\/span><\/a><span style=\"font-weight: 400;\">. If you qualify, then Medicaid will help cover costs associated with Medicare. It can help with costs such as your Part A deductibles, copays, Part B premiums, copays, and coinsurance.&nbsp;<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Medicare was signed into law by Lyndon B Johnson in 1965 and has four parts. This article will focus on Medicare Part A, which covers inpatient hospital stays, among several other services, such as subacute rehabilitation in a skilled nursing facility. What does Medicare Part A cover? When it comes to inpatient services or hospital [&hellip;]<\/p>\n","protected":false},"author":133,"featured_media":55829,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2],"tags":[608,15],"coauthors":[20918],"class_list":["post-55826","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-company","tag-health-insurance","tag-medicare","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>What is Medicare Part A?<\/title>\n<meta name=\"description\" content=\"Medicare Part A covers inpatient care in hospitals, skilled nursing facilities, hospice care, and home health care. 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