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What You Need to Know About Medicare Part A

August 21, 2020 By Matt Wolleat Comments are Off

For many Medicare-eligible individuals, enrolling in and using the program can be a confusing experience. Not only are there multiple unique parts to Medicare, but each part is designed to cover specific healthcare services, which can further complicate understanding of the program.

At Minnesota Benefit Association, our partners understand health coverage is rarely straightforward, and that’s why we’re here to be your guide. We help individuals and companies understand their health coverage options, so they can make the decisions that best meet their unique needs and goals.

In this blog, we explain what you need to know about enrolling in Medicare Part A, what it covers, and potential costs. And as always, if you have further questions, don’t hesitate to reach out to our team and ask!

What Does Medicare Part A Cover?

Medicare Part A is often referred to as hospital insurance because it provides coverage for inpatient care in hospitals. Part A coverage also extends to the following types of care:

  • Skilled nursing facility care. These facilities provide skilled, medically necessary care administered by highly trained healthcare professionals, such as nurses and licensed therapists.
  • Care in critical access hospitals. These types of small health care facilities provide critical access care to people who live in rural areas. They’re essentially tiny hospitals with more limited resources than a major hospital.
  • Hospice care. This type of skilled care provides both comfort and health care services to individuals who are approaching the end of their life.
  • Home health care. When provided on a part-time or intermittent basis, Medicare Part A provides coverage for medically necessary, skilled nursing care in the home, as well as physical therapy, occupational therapy, speech-language pathology services, and medical social services.

Though Medicare Part A provides coverage for certain types of in-home care, it does not pay for the following types of care:

  • Custodial or personal care. This type of care helps with actions that individuals typically perform by themselves, such as using the bathroom, dressing, and bathing. Medicare Part A will not cover this if it is the only type of care you require.
  • Homemaker services. This type of care includes cleaning, laundry, and shopping, among other services. If this is the only type of care you require, Part A will not cover it.
  • Round-the-clock care in the home.
  • Meal delivery to the home.

Curious whether the care you need is covered under Medicare Part A? Get in touch with us today to discuss your Medicare and supplemental health coverage options

Who Is Eligible for Coverage Under Medicare Part A?

To receive health benefits under Medicare Part A, you must meet specific conditions. Generally, you are eligible to enroll in the program if you:

  • Are 65 years of age or older and meet the residency and citizenship requirements outlined in the program conditions.
  • Have received Social Security disability benefits or disability benefits from the Railroad Retirement Board for at least 25 months.
  • Receive disability benefits because you suffer from Amyotrophic Lateral Sclerosis (ALS), also referred to as Lou Gehrig’s disease.
  • Have end-stage renal disease (ESRD) and meet certain requirements.

When Can You Enroll In Medicare Part A?

When you first become eligible to enroll in Medicare Part A, you have a 7-month Initial Enrollment Period during which you can sign up. If you will be Medicare eligible at the age of 65, you’ll need to sign up for coverage within the following time frame:

  • Starting 3 months before the month of your 65th birthday
  • During the month of your 65th birthday
  • During the 3-month period following the month of your 65th birthday

If you do not enroll in Medicare Part A during the 3-month period before you turn 65, your coverage under Medicare Part B will be delayed. And in most cases, if you do not sign up for Part B when you first become eligible, you’ll be required to pay a late enrollment penalty. You’ll continue to pay that penalty as long as you have coverage under Part B.

Does Medicare Part A Cost Money?

Generally, you won’t pay a monthly premium for coverage under Medicare Part A as long as you or your spouse paid Medicare taxes for a minimum of 10 years while you were still working. However, if you are not eligible for no-cost Part A, you may still be able to enroll in coverage, you’ll simply need to pay a premium. If you meet the following requirements, you can typically purchase Part A coverage:

  • You are 65 or older and you are enrolled (or currently enrolling in) Medicare Part B. You must also meet residency and citizenship requirements.
  • You are under the age of 65, you’re disabled, and you lost your free Part A coverage because you went back to work. Please note: If you are under the age of 65 and disabled, you can continue receiving free Part A coverage for a maximum of 8.5 years after you return to work.

It’s also important to note that if you elect to purchase Medicare Part A, in most cases, you must also have Part B, and you’ll pay monthly premiums for both types of coverage. When you use Part A to pay for your inpatient hospital expenses — whether you signed up for free or you pay a monthly premium — you’ll pay a deductible for each benefit period.

Depending on the length of your hospital stay, you may also be required to pay co-insurance. If you exceed the plan’s lifetime reserve days, you’ll be responsible for paying all of your inpatient hospital expenses.

Need Medicare Enrollment Assistance? Contact the MBA

When you have questions, our licensed advisors have answers, so give us a call at 651.358.2990