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What Does Medicare Part A Cover?

About Medicare Part A

When you’re ready to apply for Original Medicare, you’ll find it has two parts: Medicare Part A and Medicare Part B. Medicare Part A benefits include a stay in a hospital or skilled nursing facility, and services during inpatient care. Sometimes they include at-home care, and even hospice care. Medicare Part B covers regular doctor visits, preventive, and everyday healthcare.

What Does Medicare Part A Cover?

 

Hospital care coverage includes coverage for hospital expenses such as:

  • Hospital stays (semi-private rooms) up to 60 days

  • Intensive care services

  • Drugs, medical supplies, and equipment used on the premises

  • Lab tests and X-rays taken while hospitalized

  • Surgery and recovery costs

     

Home healthcare benefits are covered when they are ordered by your doctor. They include:

  • Rehabilitation and therapy services

  • Occupational therapy

  • Medical social services

  • Speech-language pathology services

  • Part-time home nursing care

     

Nursing home coverage can go into effect after a qualifying hospital stay of at least three days. It includes:

  • Semi-private room

  • Meals

  • Skilled nursing services

  • Rehabilitation services if they are necessary to treat your illness

  • Dietary counseling

 

 

What Is Not Covered Under Medicare Part A?

 

  • Doctors and specialists who care for you in the hospital (this falls under Medicare Part B)

  • Hospital stays in a private room (unless medically necessary)

  • The cost of blood, if the hospital has to buy it for you

  • Items for personal care (like shampoo) during your stay

  • Hospital stays longer than 60 days

 

 

What Does Medicare Part A Coverage Cost?

 

Most people don’t pay a premium for Medicare Part A coverage because they (or their spouse) paid into Social Security when they worked. If you do pay Medicare Part A premiums, the longer you worked and paid into Social Security, the lower your premiums will be.

 

 

What Is A Medicare Part A Deductible?

 

Medicare Part A coverage doesn’t have an annual deductible. Instead, deductibles apply to each hospital benefit period. A hospital benefit period begins when you go into a hospital or a skilled nursing facility and ends when you leave the hospital or skilled nursing facility for 60 consecutive days.

 

 

When Do Medicare Part A Copays Begin?

 

A copay is a fixed amount you pay for a medical service after your deductible. Copays for Medicare Part A coverage apply once you stay in a hospital for more than 60 days in a single benefit period. In a skilled nursing facility, your copays begin after the first 20 days.

 

 

When Are You Eligible For Medicare Part A?

 

In general, Medicare Part A eligibility requires that you be 65 or older and a U.S. citizen. If you were not born in the U.S., you must be a citizen as well as a permanent resident for at least five continuous years to qualify. You may also apply for Medicare if you are younger than 65 and have certain disabilities.

 

 

When Can You Apply For Medicare Part A?

 

You can apply for Medicare through Social Security during your Initial Enrollment Period, which is:

  • Three months before your 65th birthday month

  • Your 65th birthday month

  • Three months after your 65th birthday month

     

Medicare Part A is just the beginning of what Medicare offers. Find out more about Medicare Part B, Part C (also known as Medicare Advantage) and Part D for a full picture of your Medicare coverage options and potential costs.

 

 

 

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Other Articles From “Understanding Medicare And Its Parts” Guide

Anthem Blue Cross is an HMO & LPPO plan with a Medicare contract. For Dual-Eligible Special Needs Plans: Anthem Blue Cross is an HMO SNP plan with a Medicare contract and a contract with the California Medicaid program. Anthem Blue Cross Life and Health Insurance Company is an LPPO plan with a Medicare contract. Enrollment in Anthem Blue Cross depends on contract renewal.