What Medicare Part A Covers

There are several parts to Medicare, each of which helps cover the costs of certain essential healthcare services. Understanding the parts of Medicare can help you make informed decisions when it’s time to sign up for Medicare and choose a Medigap or Medicare Advantage plan. Medigap and Medicare Advantage plans are designed to help cover out-of-pocket healthcare costs not covered by Medicare.

Contact the Medicare experts at Karla’s Insurance today to learn more about how Medicare can help pay for your future medical needs.

What Are the Parts of Medicare?

Medicare Part A and Medicare Part B are called Original Medicare. These two parts cover the most medically necessary healthcare services and supplies in healthcare facilities.

Medicare Part C, also called Medicare Advantage, is optional. These plans are Medicare-approved from private companies and are an alternative to Original Medicare. Part C plans typically include Part A and B coverage plus prescription drug coverage.

Medicare Part D is also optional and provides some coverage for prescription drugs and many doctor-recommended vaccines or shots.

What Medical Costs Are Covered by Medicare Part A?

Medicare Part A provides hospital insurance. In general, it can help cover the following:

• Hospice care
• Home health care
• Skilled nursing facility care
• Inpatient hospital care

Medicare Part A covered services may require copayments, coinsurance or deductibles as follows:

• Blood is covered if your hospital gets blood products at no charge. If they have to pay for blood, you must pay for the first three units per calendar year when you receive a blood transfusion. Alternatively, you or someone else can choose to donate the blood.
• Home health services that are medically necessary and part-time or intermittent skilled nursing care may be covered by Part A or B if your situation meets Medicare’s criteria. These services may include speech-language pathology services, physical therapy, occupational therapy, medical social services and medical equipment or medical supplies for use at home.
• Hospice care is covered if you are terminally ill with a life expectancy of six months or less. This care is palliative and may include symptom management, pain relief, aide and homemaker services, grief counseling and other services you may need to manage pain and symptoms.
• Inpatient hospital care in a semiprivate room, including meals, drugs, hospital services and supplies, and general nursing, is covered with no deductible or coinsurance for the first 60 days of each benefit period. Coinsurance payments are required for days 61 to 90 of each benefit period. After day 90, your coinsurance amount for lifetime reserve days kicks in for up to 60 days over your lifetime, after which you are responsible for 100% of the costs of your hospital care.
• Religious nonmedical healthcare at a Medicare-approved institution is covered if you are an inpatient and qualify for care at these facilities. Medicare covers room and board and items and services that don’t need a prescription or doctor’s orders.
• Skilled nursing facility care in a semi-private room is covered after a medically-necessary limited-time stay as an inpatient in the hospital. Semi-private rooms, therapy and skilled nursing services, other medically necessary services and supplies and meals are covered for the first 20 days of each benefit period if you have Original Medicare. You are responsible for a coinsurance amount per days 21 to 100 and 100% of costs after day 100 during each benefit period.

Contact Us to Learn More About Medicare Part A Services

Medicare Part A coverage provides access to many medically necessary hospital services. Understanding your coverage is essential when deciding whether to add a Medicare Advantage plan or Medigap plan to help cover potential out-of-pocket costs.

Contact Karla’s Insurance today to get help deciding how to tailor your Medicare coverage to meet your future needs.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.