Medicare Part A is the Hospital Insurance component of Original Medicare. It frequently works in tandem with Part B to cover most hospital-related medical expenses. For some individuals, supplemental coverage may also be necessary to ensure the full range of their medical needs are insured appropriately. The starting point for making informed decisions about Part A insurance begins with understanding what Medicare Part A covers, who is eligible, and what you can expect to pay for your policy.
Medicare Part A covers hospital stays and certain treatment expenses associated with inpatient care. It can also include some longer-term inpatient costs for hospice or home health care. Unlike some other parts of Medicare, Part A does not have policy-specific network or specialist restrictions. You can visit any doctor or hospital nationwide that accepts Medicare.
Some costs that seem like inpatient expenses are actually categorized as outpatient services, and therefore are not covered under Medicare Part A. The table below breaks down some of the healthcare charges that are covered, but it’s a good idea to check with your Medicare insurance broker if you are unsure whether a specific healthcare component falls under Part A.
Medicare Part A covers hospital stays and inpatient care, including:
Your hospital room and meals
Skilled nursing services
Care in special units, such as intensive care
Some blood transfusions
Drugs and medical supplies used during an inpatient stay
Hospice care, including medications to manage symptoms and pain
Lab tests, X-rays and medical equipment as an inpatient
Part-time, skilled care for the homebound after a qualified inpatient stay
Operating room and recovery room services
Rehabilitation services after a qualified inpatient stay
Medicare Part A covers hospital stays and inpatient care, including:
Your hospital room and meals
Skilled nursing services
Care in special units, such as intensive care
Some blood transfusions
Drugs and medical supplies used during an inpatient stay
Hospice care, including medications to manage symptoms and pain
Lab tests, X-rays and medical equipment as an inpatient
Part-time, skilled care for the homebound after a qualified inpatient stay
Operating room and recovery room services
Rehabilitation services after a qualified inpatient stay
Individuals wishing to enroll in Medicare Part A must meet several criteria to successfully obtain coverage. Generally, enrollees must be aged 65 or older and have held residence within the United States for at least 5 consecutive years before making an application for coverage. Other factors like receipt of disability benefits and medical conditions like ALS (Lou Gherig’s Disease) or End Stage Renal Disease can lead to coverage eligibility before an applicant actually turns 65. If you are unsure about your eligibility status for Medicare Part A, reach out to us or visit Medicare.gov’s Eligibility Calculator to establish your coverage options.
Many people receive Medicare Part A coverage without having to pay a monthly premium. If you or your spouse held a job where Medicare taxes were paid out for at least 10 years, you will likely fall into this group. If you do not meet this minimum contribution timeline, you have the option to purchase Part A coverage if you meet the age and residence requirements mentioned above.
For individuals previously covered under a premium-free Part A plan: if you’re going back to work and can get employer health coverage that is considered acceptable as primary coverage, you are allowed to drop Medicare and re-enroll again without penalties. If you drop Medicare and don’t have creditable employer coverage, you’ll face penalties when getting Medicare back.
Those who are eligible for free Medicare Part A coverage thanks to payment of Medicare taxes during their working years do not see the same kind of late enrollment penalty. While free coverage is undeniably a good thing, there are cases in which it is actually best to defer enrolling in Part A. One such instance is if you are eligible for enrollment due to turning 65 but are still a part of the workforce.
Working individuals who are contributing to a Health Savings Account (HSA) must have a 6-month period between their last HSA contribution and enrolling in Medicare Part A. Depending on the specifics of your HSA, it may be in your best interest to defer Part A enrollment. It is important to have an insurance expert weigh in these instances to make sure you are optimizing both your health insurance coverage and your budget.
There is much more to the potentially cost-free Medicare Part A than meets the eye. We understand that navigating the ins and outs of Medicare can be tricky, which is why we are here to help! If you have questions about Part A or any other Medicare component we have yet to cover, please drop us a line or give us a call. We also welcome all curious minds to attend our upcoming informational events. These informal gatherings are offered at no cost and a great way to learn more about Medicare. We look forward to seeing you!
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