Hospital Coverage
What is Medicare Part A?
There are different parts of Original Medicare. You will have hospital insurance (Medicare Part A) and medical insurance (Medicare Part B). Part A, the hospital insurance, will cover inpatient care, such as staying in a hospital, living in a skilled nursing facility, and some medical services that may be needed while living at home.
What is The Premium cost for Part A?
Premium-free Part A
You usually don’t pay a monthly premium for Medicare Part A (Hospital Insurance) coverage if you or your spouse paid Medicare taxes for forty quarters (ten years) during your working life. This is sometimes called “premium-free Part A.” Most people get premium-free Part A.
You can get premium-free Part A at 65 if:
- You already get retirement benefits from Social Security or the Railroad Retirement Board.
- You’re eligible to get Social Security or Railroad benefits but haven’t filed for them yet.
- You or your spouse had Medicare-covered government employment.
If you’re under 65, you can get premium-free Part A if: - You got Social Security or Railroad Retirement Board disability benefits for 24 months.
- You have End-Stage Renal Disease (ESRD) and meet certain requirements.
Part A premiums
If you don’t qualify for premium-free Part A, you can buy Part A.
People who buy Part A will pay a premium of either $259 or $471 each month in 2021 depending on how long they or their spouse worked and paid Medicare taxes. If you choose NOT to buy Part A, you can still buy Part B.
In most cases, if you choose to buy Part A, you must also:
- Have Medicare Part B (Medical Insurance)
- Pay monthly premiums for both Part A and Part B
Contact Social Security for more information about the Part A premium.
What does Medicare Part A cover?
Medicare Part A covers several medical services which include the following:
- Inpatient care – Some of these things would consist of meals, semi-private rooms, nursing services, inpatient treatment medications, supplies used from the hospital during their inpatient stay, and some other services.
- Hospice care – If a doctor has determined that a patient is terminally ill and will only live for six months or less, they could get Part A coverage for hospice.
- Care received during a stay in a skilled nursing facility – Nursing home stays will be covered with Part A if the patient had an inpatient hospital stay first for the related injury or illness (this does not include custodial or long-term care).
- Nursing home care (inpatient care in a skilled nursing facility that’s not custodial or long-term care)
- Home health care – If it is ordered by a doctor and deemed to be medically necessary.
Some services are only covered in certain facilities. There are also times when Medicare Part A will only cover a patient with certain conditions. It is always a good idea to speak with a Medicare specialist if you have questions about any Medicare plan.