MEDICARE
Part A Explained
More and more employers are beginning to integrate
wellness programs into their benefits. Learn more.
MEDICARE
Part A Explained
More and more employers are beginning to integrate wellness programs into their benefits.
Learn more.
What is Medicare Part A?
Original Medicare consists of two parts: Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Medicare Part A covers Medicare inpatient care, including care received while in a hospital, a skilled nursing facility, and, in limited circumstances, at home.
Most people are automatically eligible for Medicare Part A at age 65 if they’re already collecting retirement benefits from the Social Security Administration or the Railroad Retirement Board. You may qualify for Medicare Part A before 65 if you have a disability, end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS). You must be either a United States citizen or a legal permanent resident of at least five continuous years.
Medicare Part A Coverage
In general, Part A covers:
- Hospital care
- Skilled nursing facility care
- Nursing home care (as long as custodial care isn’t the only care you need)
- Hospice
- Home health services
It is important to note that Part A does NOT cover Long Term Care. We recommend that people who also want Long Term Care (LTC) coverage research various types of policies separate from Medicare.
Medicare Part A Eligibility
You are eligible for Medicare Part A if:
- I would clarify that people with a disability are only eligible for Medicare after receiving disability benefits for 24 months
- You are age 65 or older and a U.S. citizen or permanent legal resident of at least five years in a row
- You are already receiving retirement benefits
- You are disabled and receiving disability benefits
- You have end-stage renal disease (ESRD)
- You have amyotrophic lateral sclerosis (Lou Gehrig’s disease or ALS)
Most beneficiaries do not pay a premium for Medicare Part A if they have worked at least 10 years (or 40 quarters) and paid Medicare taxes during that time. Individuals who aren’t eligible for premium-free Medicare Part A can still enroll in Part A and pay a premium. Beneficiaries who delay enrollment after they first become eligible for Medicare Part A may be subject to a late enrollment penalty once they sign up.
Medicare Part A Costs
If you only have Original Medicare, you may incur these costs by not also having a medicare supplement plan:
| Part A costs: | What you pay in 2022: |
|---|---|
| Premium |
$0 for most people (because they paid Medicare taxes long enough while working – generally at least 10 years). This is sometimes called “premium-free Part A.” If you don’t qualify for a premium-free Part A, you might be able to buy it. In 2022, the premium is either $274 or $499 each month, depending on how long you or your spouse worked and paid Medicare taxes.
|
| Deductible | $1,556 for each time you’re admitted to the hospital per benefit period, before Original Medicare starts to pay. There’s no limit to the number of benefit periods you can have. |
| Inpatient stays (copayments) |
Days 1-60: $0 after you pay your Part A deductible Days 61-90: $389 each day Days 91-150: $778 each day while using your 60 lifetime reserve days After day 150: You pay all costs |
Tip
If you are currently on your employer’s health plan, you may be able to pair Medicare Part A with your health plan and have it as either primary or secondary coverage.
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FREQUENTLY ASKED QUESTIONS
Does my hospital accept Part A?
Hospitals must adhere to certain safety and health regulations to participate with Medicare. The Medicare.gov website contains a useful Hospital Locator Tool, which allows you to enter your city, state, or zip code to find a list of hospitals in your area that accept Medicare.
Will I experience out-of-pocket costs with Part A?
Under Original Medicare coverage, you are responsible for your Part A deductible and coinsurance, even if your hospital accepts Medicare assignment, there is no cap on your out-of-pocket expenses.
If you’re enrolled into a Medicare Supplement plan, these costs may be covered by the insurance carrier completely or partially.
It is important to note that if you have only original medicare, there is no limit on out-of-pocket costs.
Kellie Reed
Insurance Services
Medicare and Health
insurance Plans
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