What Does Medicare Part A Cover?

Understanding Medicare can be a lot to take in, especially with the many components that compose the program. Medicare Part A is one of the four parts of Medicare, and is the most commonly used Part. Learning what Medicare Part A covers is essential in understanding how you can benefit from the program.

Part A: Hospital Insurance

Medicare Part A, also known as hospital insurance, is what covers inpatient hospital care, inpatient care in a skilled nursing facility, and limited at-home health care services. This coverage is especially beneficial for those who are over the age of 65 or receive Social Security Disability Insurance. As long as you have paid into the Medicare system through payroll taxes, Part A is considered a premium-free benefit.

Part A covers many stay-related hospital services, such as doctor’s fees, nursing care, meals, hospital services and supplies, and more. When over 65, Part A also covers trauma rehabilitation, extended care such as respite care, and home health care.

Part A Coverage Utilization

As long as you are receiving hospital care in an eligible facility, you can take advantage of Part A’s coverage of inpatient hospital services. Examples of common services covered by Part A include surgeries, laboratory tests, and hospital nursing. Generally speaking, Part A covers any services required for the diagnosis, treatment, and care of a condition.

Outpatient services such as an office visit are not included in Part A coverage, so you would have to select a different Part of Medicare to cover these services. If you receive hospice services or have any medical equipment needs, these would also not be covered by Part A.

In terms of the duration of Part A coverage, most Medicare plans provide up to 60 days of inpatient hospital care coverage with a deductible. For those who require extended hospitalization and Medicare Part A coverage for more than 60 days, you’ll need to pay up to 60 additional “lifetime reserve days” and a daily coinsurance for a total of 150 days of coverage.

Costs Associated With Part A

If you are over 65 and received Social Security Disability Insurance, Part A is premium-free. However, if you have never worked and thus do not receive Social Security Disability Insurance, you will need to pay a premium of up to $437 a month in order to qualify for Part A.

In terms of a deductible, the first 60 days of inpatient hospital care are covered with Part A and do not require a deductible. After the first 60 days, you’ll be responsible for up to $1,408 per day if you choose to utilize the remaining “lifetime reserve days.” Additionally, you’ll need to pay a coinsurance for hospital stays more than 60 days up to the benefit limit of 150 days.

Conclusion

Medicare Part A is a great form of coverage for those over 65 and receiving Social Security Disability Insurance. With Part A, you can receive up to 60 days of inpatient hospital care services, such as doctor’s fees, lab tests, hospital services and supplies, nursing care, and more – all without having to pay a premium, as long as you previously worked and paid the necessary payroll taxes. If you need extended hospitalization, you can use the remaining “lifetime reserve days” and will need to pay a deductible and coinsurance. Medicare Part A helps provide comprehensive coverage and keep costs low, so you can focus on getting better and nothing else.