Medicare Part A
(Hospital Insurance)

Medicare Part A is your hospital coverage. It provides you with affordable inpatient care. So what’s the definition of inpatient?

You may get your inpatient care at an acute care hospital, a critical access hospital, an inpatient mental healthcare hospital or at an inpatient rehabilitation facility.



Medicare Part A Highlights

How it Works

Medicare Part A was first signed into law in 1965 to provide healthcare for US citizens over 65 years of age.  Medicare Part A was introduced to provide inpatient hospital services.

Eligibility

You are eligible to enroll in Part A when you turn 65 or 24 months after been collecting disability benefits, or if you have End Stage Renal Disease (ESRD)

Benefits

Medicare Part A covers your hospital stays, home care, hospice care, and skilled nursing facilities.



Premium Cost

For most, there is no premium for Medicare Part A. However some people may have to pay Premium



Enrollment

you are enrolled automatically enrolled in Part A if you are collecting Social Security benefits at the time you become eligible for Medicare. Otherwise, you have to apply to get Part A

Cost-Sharing

Although you may not pay a premium for Part A, you may have to pay deductibles, copays and coinsurance when you use services covered under Part A

How does Medicare Part A Work?

How does Medicare Part A Work?

Medicare Part A was first signed into law in 1965 to provide healthcare for US citizens over 65 years of age. Medicare Part A was one among the two part of Original Medicare. In 1966 Medicare Part A became effective for more that 19 million US citizens. Medicare Part A was introduced to provide inpatient hospital services. Inpatient services include most of the services you receive when are hospitalized such as hospital stays, meals, lab services, diagnostic services, and more. For most people, monthly premium for Part A is $0 for beneficiaries or their spouses worked more than 10 years (40 quarters) and payed Medicare taxes.

Medicare Part A Eligibility

Medicare Part A Eligibility

You are eligible for Medicare Part A at age 65 as well. However, you can be eligible for Part B under the age of 65 if:

If you are in a situation where you would like to learn whether it is wise to give up your employer's healthcare insurance or not, you should meet with one of our Medicare Advisors to provide you guidance. There are many factors in play in the decision including premiums, out-of-pocket costs like deductibles, copays, medications costs and so forth. We will show the math and give you our expert opinion and the decision is your at the end.

Medicare Part A Benefits

Medicare Part A Benefits

Part A covers hospital services like hospital stays, medications given when hospitalized, hospital meals and so forth. In addition to Medicare hospitalization coverage, Part A also covers skilled nursing home, home healthcare and physical therapy for post-hospitalization, and hospice care.

Below is a list of some of the services covered under Part A:

Hospital Stays

Hospital
Stays

Basic Hospital Meals

Basic Hospital
Meals

Medically Necessary Medications

Medically
Necessary Medications 

In-Hospital Lab Services

In-Hospital
Lab Services

Home Health Care

Home
Health Care

Nursing Home Facilities

Skilled Nursing
Home (SNF)

Hospice Care

Hospice
Care

Part B does not cover Dental, Vision, and Hearing Aid Services, and Prescription Drugs.

Dental Services Not Covered

Dental Services

Vision Services Not Covered

Vision Services

Hearing Services Not Covered

Hearing Services

Prescription Drugs Not Covered

Prescription Drugs

Medicare Part A Premium Cost

Medicare Part A Premium Cost

Medicare Part A is premium-free for most people. If you and/or your spouse have worked in the United States for 10s of years, you have already paid years of Social Security Taxes, you already paid lots of money for your Medicare Part A. So it is a myth to state that Part A. These taxes you paid offset the cost of Medicare Part. However, if you have not worked in the United States for required period of time, you may have to pay for Medicare Part A. The amount of premium you pay for Medicare Part A depends on how long you and/or your spouse worked in the US.

$0 per month

If you and/or your spouse worked in the United States for 10+ years (or 40+ quarters)


$278 per month

If you worked in the United States for less than 40 quarters but more than 30 quarters, provided you are US permanent resident for at least 5 years

$506 per month

If you worked in the United States for less than 30 quarters, provided that you are US permanent resident for at least 5 years

Medicare Part A Enrollment

Medicare Part A Enrollment

If you have been collecting Social Security Income (SSI) or Railroad Retirement Benefits (RRB) for at least 4 months before you turned 65, you will be automatically enrolled in Part A. Your Part A starts on the 1st day of your 65th Birthday month. Your Medicare ID Card should arrive in your mailbox as early as 3 months before you turn 65 years old! If you have not been collecting SSI or RRB benefits for at least 4 months before you turned 65 or you have not worked for 40 or more quarters in the United States, you will have to manually apply to enrolled in Part B. You can enroll in Part A and/or B manually by calling or visiting your local Social Security Office. You can also file online at www.ssi.gov. We can help with all these at no charge to you as well.

Medicare Part A Cost-Sharing

Medicare Part A Cost-Sharing

Although Medicare Part A is premium-free for most and it covers a wide range inpatient medical services. However, you are responsible for cost-sharing when using services covered under Part A. Each year, CMS determines the how much cost-sharing you are responsible for including deductible and coinsurance.

Hospital Stays Cost-Sharing

There are deductibles and coinsurance for hospitals stays as shown in the the chart below:

Deductible

Under Part A, for each benefit period you will pay your Part A deductible of $1,600 (set by Medicare for year 2023). This deductible will cover you for the first 60 days of your hospital stay.

Days 61 to 90

You will pay a coinsurance of $400 (set by Medicare for year 2023) each day in the hospital of each Benefit period.



Days 91 to 150

You will pay a coinsurance of $800 (set by Medicare for year 2023) each day in the hospital of each Benefit period.



150 Days and Beyond

Any and all costs past your Lifetime Reserve Days.





Skilled Nursing Facility (SNF) Cost-Sharing

There are deductibles and coinsurance for staying in Skilled Nursing Facility as shown in the the chart below:

Days 1 to 20

Under Part A, Medicare pays for the first 20 days of your Skilled Nursing Facility stay.


Days 21 to 100

You will pay a coinsurance of $194.50 (set by Medicare for year 2022) each day in the Skilled Nursing Facility (SNF).

Days 101 and Beyond

You pay all costs for each day after day 100 for Skilled Nursing Facility (SNF).


Frequently Asked Questions (FAQs)

Medicare Part A has a late enrollment penalty that apply for those who missed to enroll when they first become eligible. If you were eligible for Part A for 2 years but didn't sign up, you'll have to pay the higher premium for 4 years. Usually, you don't have to pay a penalty if you meet certain conditions that allow you to sign up for Part A during a Special Enrollment Period (SEP).

If you are covered by an employer group insurance with creditable coverage, you may delay Medicare Part A past 65. However, most people keep Part A because it is premium-free and it will act a secondary insurance to their group insurance.

If you delayed enrollment in Part A and later would like to apply for Part A, you will then have 8 months window of Special Enrollment Period (SEP) to apply.

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