Medicare Part A
Covers Your Hospitalization Costs
Medicare part A is the portion of Medicare that covers hospital expenses. You must be eligible for this
coverage by being age 65 or older or being younger with a qualifying disability. Those who have paid into Medicare for ten years or more are usually
entitled to Medicare coverage without having to pay a monthly premium. If you were employed for less than ten years
and did not pay into the Medicare fund, then you will be required to pay a monthly premium that is prorated for the
number of years you worked.
If you are eligible for Medicare but cannot afford the
premiums because of low income, you may be able to get assistance from the government through a program like the
Specified Low Income Medicare Beneficiary Program or the Qualified Disabled Working Individuals Program.
Eligibility for these programs is based upon monthly income. If you don't sign up for Medicare as soon as you are
eligible, you will have to pay higher fees for a period of time equal to twice as long as you went without it. For
example, if you don't sign up for Medicare until a year after you are eligible, then you will have to pay a higher
premium for two years.
Medicare part A pays for inpatient hospital costs. This includes paying for a
semi-private room, medications, treatments, supplies, and services. The type of facilities covered are acute care
hospitals, emergency hospitals, inpatient rehab facilities, long term care facilities, mental health hospitals, and
inpatient clinical research facilities. While Medicare part A pays medically necessary costs, it does not pay for
private duty nurses, televisions, phones, private rooms, and personal care items like razors and socks.
Medicare part A pays for care in a skilled nursing facility for a set amount of time
immediately following a qualifying three day hospitalization. To qualify, you must need some sort of on-going
nursing care like IV treatments or physical therapy on a daily basis. Medicare part A does not pay for long term
nursing home placement.
Medicare part A also covers expenses associated with end of life care. To be eligible
for hospice coverage, the physician must certify that the patient is expected to live less than six months. Care
can be given in the home, hospice facility or nursing home and coverage is extended to medications, treatments, and
services.
Medicare part A will also provide respite coverage as long as care is given in a
Medicare approved facility and is five days or less. This allows caregivers a chance to rest and take time off from
caring for a terminally ill patient at home. For patients that are homebound, Medicare part A will pay for home
health care that includes visits by nurses and therapists. Costs for durable medical equipment are also covered
under part A.
If you require blood transfusions in the hospital, the cost may not always be covered
under Medicare part A. If the hospital is able to secure the blood from a local blood bank you will not have to pay
for it but if the hospital has to buy it from private donors, you will be responsible for the cost.
Medicare part A pays for medications you receive while you are in a qualifying
treatment center but it does not pay for medications you take at home on a regular basis. Other medical costs you
won't be covered for include dentures and routine dental care, cosmetic surgery, hearing aids, and
acupuncture.
If you receive SSI disability, you will automatically be enrolled in Medicare part A
when you are eligible. You can tell if you have coverage by looking at your Medicare ID card which displays both
your Medicare part A and Medicare part B ID numbers if you are covered. If you are enrolling because you are
approaching 65, you should sign up at least three months before your birthday.
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