Parents on Medicare? Part A: What Is It and What Does It Cover?

Medicare is a healthcare program for persons 65 and above, those under 65 with certain disabilities, and people of any age with End-Stage Renal Disease (ESRD). Medicare is divided into parts: Part A, Part B, Part C, and Part D.

• Part A covers inpatient hospital care, including critical access hospitals and skilled nursing facilities. It also includes hospice care and home health care.
• Part B covers outpatient care, preventative services, durable medical equipment, and some home health services.
• Medicare Part C, often known as Medicare Advantage, is a private health insurance plan that provides Medicare benefits.
• Part D of Medicare is a prescription drug benefit provided to all Medicare recipients. It is provided by private insurance firms and helps cover recommendation drug expenses.

So now that we know what each part of Medicare covers, let’s take a closer look at Part A.

Medicare Part A covers hospital inpatient care, skilled nursing facility care, hospice care, and home health services.

Inpatient hospital care is when you’re admitted to the hospital as an inpatient and stay overnight. This can include tests, treatments, and surgeries. Part A also covers semiprivate rooms, meals, general nursing care, and other hospital services and supplies such as inpatient care in critical access hospitals and inpatient mental health care.

Skilled nursing facility care is when you need daily skilled nursing or rehabilitation services after a hospital stay. Part A covers semiprivate rooms, meals, skilled nursing, and rehabilitation services. It also covers physical, occupational, and speech therapy.

Hospice care is for people with a terminal illness who are not expected to live more than six months when they’re terminally ill and have chosen to focus on comfort rather than cure. Part A covers hospice services, including pain relief, home health aides, homemaker services, and symptom management. It also covers grief counseling for you and your family and respite care to give your primary caregiver a break.

Home health services are used when you require intermittent skilled nursing care or therapy. Your doctor must order these services, and they must be provided by a Medicare-certified home health agency. Services that may be covered include skilled nursing care, physical therapy, occupational therapy, speech-language pathology services, and medical social services.

Medicare Part A Cost

For most people, Medicare Part A is free. You usually do not have to pay a monthly fee for Part A coverage if you paid Medicare taxes while working.

If you are not eligible for free Part A, you may purchase it if certain conditions are met. You can get Part A at age 65 without having to pay premiums if you:

• receive Social Security or Railroad Retirement Board retirement benefits.
• are eligible for Social Security or Railroad Retirement benefits but have yet to begin receiving them.
• or your spouse worked for the government and were covered by Medicare.

If you must purchase Part A, you will spend up to $458 per month. It also has deductibles. The precise amount is determined by how long you worked and paid Medicare taxes. Also, if you have a low income, you may be able to get assistance with your Part A premiums and other out-of-pocket expenses.

Medicare Part A Eligibility

To be eligible for Medicare Part A, you must be:

• A U.S. citizen or permanent legal resident: You or your spouse must have worked for at least ten years and paid Medicare taxes.

• Age 65 or older: If you are under 65, you may be eligible if you have specific disabilities, received Social Security disability benefits for at least 24 months, or have amyotrophic lateral sclerosis (ALS) or end-stage renal disease.

People with ALS receive Part A benefits automatically the month their disability benefits begin.

The rules for people with ESRD are complicated. The waiting period for Part A begins the fourth month of dialysis unless you have a kidney transplant before then. If you have a kidney transplant, your coverage begins the month of your transplant.

If you are unsure whether you are eligible for Medicare Part A, you can contact the Social Security Administration or the Medicaid office in your state. Medicaid program is not the same as Medicare program, to learn more visit this page.

Medicare Part A Enrollment

When most people reach the age of 65, they become eligible for Medicare. If you already receive Social Security or Railroad Retirement Board payments, you will be immediately enrolled in Medicare Parts A and B.

Suppose you aren’t already getting these benefits. In that case, you can enroll in Medicare during the seven-month period beginning three months before your 65th birthday, including your birthday month, and ending three months after your birthday.

You can also enroll in Medicare during the annual General Enrollment Period, which runs from January through March. If you enlist at this time, your coverage will start in July of that year.

Conclusion

If your parents qualify for Medicare, they should sign up for Part A as soon as possible. Doing so will help ensure they have the coverage they need in case of an unexpected health event. Medicare Part A is an essential component of the Medicare program as it assists in the coverage of inpatient, skilled nursing facilities and home health care. While Medicare Part A has no monthly premium, you may still have to pay deductibles and coinsurance: these costs can add up, so it’s essential to understand what they are and how they work.