The Basics of Medicare Part A
Forming 50% of the Original Medicare plan, Part A works with Part B to provide policyholders with coverage for their care at home, in a hospital, or at a skilled nursing facility. Most of the costs that this section covers will be associated with inpatient care expenses. For all other expenses, you will need to see if they are covered under another part of the Medicare Plan.
While beneficiaries will have to pay a portion of the cost when they use Medicare Part A, there is a good chance that monthly premiums will be waived. The Social Security office takes into account the number of years you have worked in the United States. If it is greater than 10 years, you could be offered a lower or deferred premium payment. This means that the burden to file Medicare claims for services will fall on suppliers and doctors, not beneficiaries.
What Coverages Are Available Under Medicare Part A?
The focus of Medicare Part A is to offer coverage for both the care and services provided in an inpatient hospital setting. For example, expenses such as semi-private rooms, medications, meals, nursing services, and other specified services obtained during a stay at a medical facility would fall under the plan. For reference, Medicare Part A will work in any of the following settings:
- Acute care hospitals
- Long-term care hospitals
- Qualifying clinical research trials and studies
- Mental health care facilities
- Critical access hospitals
- Inpatient rehabilitation facilities
Once you have stayed in a hospital’s inpatient wing for longer than three days, Medicare Part A will begin to cover your treatment costs. Doctors will often suggest a skilled nursing facility if a patient needs to have consistent care around the clock at a skilled facility and has already had a lengthy hospital stay. In this instance, Medicare would provide coverage for the following services:
- Medical social services
- Dietary counseling
- Meals
- Semi-private rooms
- Ambulance transportation when needed
- Rehabilitation services
Lastly, Medicare Part A does provide some benefits when home health care services are needed. Mostly, occupational therapy, intermittent skilled nursing care, durable medical devices, speech-language pathology services, and physical therapy would be covered. Unfortunately, at this time, the plan does not cover expenses associated with meals, 24-hour home care, and homemaker services.
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As you decide if Medicare is the right type of insurance for your needs, it is important to have a good understanding of each part of the plan. For more information on Medicare Part A or any other Medicare-related questions, give us a call today at (440) 230-1223. One of our expert agents will assist you in making the best choice for your insurance needs.