Medicare Part A is a health insurance program that helps to pay for inpatient hospital stays, skilled nursing facility care, and hospice care. It also covers some home health services.
How Was Medicare Part A Designed?
Medicare Part A was designed in 1966 to pay for the hospital costs of people covered by Social Security’s Old-Age, Survivors and Disability Insurance (OASDI) program. Medicare Part A was designed to provide financial protection against the costs associated with a hospital stay or other medical treatment that requires confinement in a skilled nursing facility or hospice program. It’s also designed to protect beneficiaries from large out-of-pocket expenses when they need to use these services.
Eligibility For Medicare Part A
If you are eligible for Medicare, you will automatically be enrolled in Medicare Part A. This coverage is free to most people who have worked long enough to qualify for Social Security or Railroad Retirement benefits. You may also be able to purchase coverage if you have been paying into Social Security but were not able to work long enough before retirement age due to disability.
What Does Medicare Part A Cover?
Medicare Part A covers hospitalization, hospice, home health care, and nursing home care for people who are eligible for the Medicare program. If you have Medicare Part A, you may also be able to get a low-cost Medicare supplement plan to help pay your out-of-pocket costs.
Hospitalization Benefits Under Medicare Part A
Hospitalization refers to being admitted to a hospital and receiving treatment there. Medicare Part A pays for hospital stays when they are medically necessary and not covered by other insurance plans or policies. It also pays for some services outside the hospital, such as diagnostic tests or surgeries performed under anesthesia at an outpatient surgical center (OSC).
Hospice Benefits Under Medicare Part A
Medicare Part A covers hospice care for terminally ill patients who have decided not to seek curative treatment. Patients can receive hospice care in their homes or facilities. Medicare pays for hospice care until a patient’s death.
Home Health Care Under Medicare Part A
Medicare Part A also pays for home health care services to people with serious illnesses or injuries that require skilled nursing care or rehabilitation therapy. These services can be provided by home health agencies hired by Medicare or by a person’s own doctor or other medical providers. The services must be performed by a licensed nurse or other qualified health professionals under the supervision of a doctor or nurse practitioner who has written orders on file with Medicare before they begin providing care.
Skilled Nursing and Nursing Home Care Under Medicare Part A
Medicare doesn’t cover anything related to daily living activities and long-term care. These activities include toileting, bathing, feeding, and more. Part A will cover your medical expenses while in a skilled nursing facility.
How Much Does Medicare Part A Cost?
Medicare Part A covers hospital stays, skilled nursing facilities, and hospice care. Medicare Part A’s monthly premium is $274 or $499 per month in 2022. Your work and payroll tax history determine the amount you’d pay.
Cost For Services Under Medicare Part A
The cost of most services under Medicare Part A is based on your income. If you have moderate or low income, your cost is limited to a specific percentage of the national average charge for the same service in your area. This amount changes yearly based on the Consumer Price Index (CPI). For 2022 the annual deductible is $1,556. Additionally, at certain levels, you are required to pay a daily out-of-pocket amount with no limit on the out-of-pocket expenses in any given year.
How Does Medicare Supplement Insurance Help Pay for Medicare Part A Costs?
Medicare supplement plans will help pay your coinsurance and deductibles for hospital stays if you go into a hospital and need medical treatment. If you have a plan with prescription drug coverage (PDC), it will also help pay for non-preventative prescription drugs that are not covered under Original Medicare Parts A and Part B. You may need to purchase an additional plan in order to get PDC benefits or prescription drug coverage.