Medicare Part A Information
Medicare Part A is automatically given to you the first day you turn 65, are a citizen of the United States, and have paid taxes from working*. For individuals under 65 and with certain disabilities, Part A starts after receiving disability benefits from Social Security for 24 months. If you have ALS, you get Part A and Part B the month your disability benefits begin.
*If you or your spouse paid sufficient Medicare taxes while working (most people), Part A is premium-free . If you have to buy Part A, you may have to pay up to $407 each month.
What does Medicare Part A Cover?
Medicare Part A covers inpatient hospital care, inpatient skilled nursing facility care, hospice, home health care services, and inpatient care in a religious non-medical health care institution. If you are unsure whether you have Part A coverage, look at your Medicare card for the Part A effective date.
Part A Covered Services
If there is blood available at a blood bank, the hospital gets the blood at no charge. You won’t have to pay for the blood or replace it. If there is a shortage of blood, you must pay the first 3 units of blood you receive in a calendar year. Blood can be donated by you or someone else to help prevent paying for the first 3 units of blood.
Medicare Part A covers medically necessary home health care services. You must see a doctor face-to-face so they can certify that you need home health care services.
You pay nothing for the cost of home health care services and 20% for durable medical equipment that is Medicare-approved.
Part A Coverage for hospice care includes: Drugs, items and services
needed for pain relief and symptom management, medical, nursing, social services, certain durable medical equipment, and services that Medicare doesn’t usual cover (spiritual and grief counseling). A doctor must certify that you’re terminally ill and expected to live 6 months or less to receive Part A hospice care. There is a copay for outpatient prescription drugs for pain and symptom management.
Medicare Part A coverage includes hospitals, critical access hospitals, inpatient rehabilitation facilities, long-term care hospitals (not long-term care), inpatient care as part of a qualifying research study, and mental health care.
There is a Part A deductible for hospital days 1-60. The Medicare hospital annual deductible in 2015 is $1,260. There is no coinsurance for these days.
Days 61-90 have coinsurance you have to pay each benefit period. $315 a day per benefit period.
Days 91+ you there is coinsurance per lifetime reserve days (60 over lifetime). $630 a day for days 91-150. After lifetime reserve days are used, you pay 100% of the cost.
*Inpatient psychiatric care in a freestanding psychiatric hospital limits you to 190 days in a lifetime.
- Skilled Nursing Facility Care
You must have a 3-day minimum medically necessary inpatient hospital stay for a related injury or illness for Part A to pay it’s share. If you don’t have a 3-day minimum inpatient hospital stay, Medicare will not pay. The 3-day stay does not include the day you are discharged. Doctors must certify that you need skilled care.
Days 1-20 are provided at no cost to you. $0
Days 21-100: $157.50 per day
After day 100, Medicare doesn’t pay for skilled nursing facility care.
Learn more about Medicare Part A by downloading the “Medicare & You ” handbook.