This week, I’ll be looking into the various parts of Medicare, trying to unscrew the inscrutable.
Today, let’s delve into at Medicare Part A
There’s a lot of information out there; here are some of the highlights:
What does it cost?
Usually, there is no monthly premium for this, if you or your spouse paid Medicare taxes for a certain amount of time while working and you are 65 or older.
You can sign up for it if you don’t fully qualify. If you buy Part A, you’ll pay up to $413 each month in 2017. If you paid Medicare taxes for less than 30 quarters, the standard Part A premium is $413. If you paid Medicare taxes for 30-39 quarters, the standard Part A premium is $227. But most folks have been paying Medicare tax for longer than that, so there will be no monthly premium.
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.
What does it do?
In a nutshell, Part A covers:
Skilled nursing facility care
Nursing home care (as long as custodial care isn’t the only care you need)
Home health services
Medicare A covers services (like lab tests, surgeries, and doctor visits) and supplies (like wheelchairs and walkers) considered medically necessary to treat a disease or condition.
If you’re in a Medicare Advantage Plan or other Medicare plan, you may have different rules, but your plan must give you at least the same coverage as Original Medicare. Some services may only be covered in certain settings or for patients with certain conditions.
As a Medicare Part A beneficiary, you will receive coverage for hospital expenses that are critical to your inpatient care, such as a semi-private room, meals, nursing services, medications that are part of your inpatient treatment, and any other services and supplies from the hospital. This includes inpatient care that is received through:
Acute care hospitals
Critical access hospitals
Inpatient rehabilitation facilities
Long-term care hospitals
Mental health care
Participation in a qualifying clinical research study
Medicare Part A hospital insurance does not cover the costs for a private room (unless medically necessary), private-duty nursing, personal care items like shampoo or razors, or other extraneous charges like telephone and television.
Medicare Part A also does not cover the cost of blood. You do not need to pay anything if the hospital gets it from a blood bank at no charge. If the hospital does need to purchase blood for you, you must pay for only the first three units that you receive each calendar year, unless you have the blood donated by you or someone else.
How do I get it?
Some people get Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) automatically and other people have to sign up for it. In most cases, it depends on whether you’re getting Social Security benefits.
Medicare is managed by the Centers for Medicare & Medicaid Services (CMS). Social Security works with CMS by enrolling people in Medicare. You don’t need to sign up for Medicare each year. However, each year you’ll have a chance to review your coverage and change plans.
Some of this information came from Medicare.gov
There is lots more information there, if you need it.
Some good information here, too: Ultimate Guide to Medicare
Let me know in the comments if you have any questions and I’ll do my best to answer them.