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Medicare Part A

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

What is Medicare Part A and What does it cover?

Medicare Part A is hospital insurance. It will typically cover any inpatient stays in the hospital that you might have. It will also often cover skilled nursing care, hospice care, and limited home health services. Patients will usually pay a deductible as well as coinsurance and/or copayments with this type of Medicare.

Inpatient Hospital Care

Medicare Part A will cover inpatient hospital care when the following are true. First, you need to be admitted to the hospital as an impatient after getting an official doctor’s order that says you require inpatient care for your injury or illness. Second, the hospital needs to accept Medicare. Sometimes, the Utilization Review Committer at the hospital will approve your stay at the hospital.

Medicare-covered hospital services include meals, general nursing, drugs as part of the inpatient treatment, hospital services and supplies, and semi-private rooms. If the care requires that you stay in a psychiatric hospital, there is a lifetime limit of 190 days.

It will not include private rooms unless it is a medical necessity. It also doesn’t include private-duty nursing or personal care items.

The cost is the $1,408 deductible for each benefit period. Days one through 60 will have $0 coinsurance for each benefit period. Days 61 to 90 require $352 coinsurance per day of each benefit period. Days 91 and up require $704 coinsurance per each lifetime reserve day after 90 for each benefit period up to 60 days over your lifetime. When you go beyond the lifetime reserve days, you’re responsible for all costs.

Skilled Nursing Facility Care

Some of the types of services that may be covered under Medicare Part A include having a semi-private room, meals, skilled nursing care, physical therapy, occupational therapy, medications, medical social services, dietary counseling, and swing bed services. Visit Medicare.gov to learn how to qualify.

When using Original Medicare, the cost for this service for days one through 20 are $0 for each benefit period. For days 21 to 100, the cost is $185.50 coinsurance per day of each benefit period. You are responsible for all costs for day 101 and up.

Resources: https://www.medicare.gov/coverage/inpatient-hospital-care https://www.medicare.gov/coverage/skilled-nursing-facility-snf-care https://www.medicare.gov/coverage/long-term-care-hospital-services

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Medicare: Things to consider

  • What are the costs?
  • What does the plan cover?
  • How does it effect other coverages?
  • Do you need to join a Medicare Prescription Drug Plan?
  • What are the Doctor and Hospital coverage options?
  • What is the quality of care?
  • Does it include travel coverage?
  • How does Medicare work?
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