Medicare Part A: The BasicsPosted by Medicare Made Clear
Many people new to Medicare don’t know a lot about it. We’re here to help you learn the basics from the beginning—with Part A.
Medicare Part A is hospital insurance. It is one part of what’s called “Original Medicare.” The other part is Medicare Part B. Part B is medical insurance.
Who can get Medicare Part A?
Eligibility for Part A is the same as for Medicare overall. You must be a U.S. citizen or legal resident living in the U.S. for at least five years in a row. You must also meet one of the following conditions:
- You are age 65 or older.
- You are under age 65 and have a qualifying disability
- You are any age and have End Stage Renal Disease (ESRD)
What does Medicare Part A cover?
Medicare Part A helps pay for inpatient hospital stays. Part A may also help cover care in a skilled nursing facility, hospice care for the terminally ill and some skilled in-home care for the homebound.
Services and items usually covered by Part A include:
- Hospital meals
- Prescription drugs and medical supplies during a hospital stay
- Laboratory tests, X-rays and radiation therapy received while in the hospital
- Operating and recovery room services
- Rehabilitation services
What does Medicare Part A cost?
Medicare Part A is premium free as long as you or your spouse made payroll contributions to Social Security for at least 10 years (40 quarters). Otherwise, you may have to pay a monthly premium of up to $411 in 2016. Medicare Part A has a deductible of $1,288 per benefit period in 2016.
After the deductible, Medicare Part A covers most of the Medicare-approved cost of hospital stays lasting up to 60 days. Patients who are in the hospital longer may be charged a co-insurance for each additional day ($322 per day in 2016).
“Lifetime reserve” days may be used to help pay for hospital stays longer than 90 days. The co-insurance is $644 per day in 2016. Once a lifetime reserve day is used, it’s gone forever.
How do I enroll in Medicare Part A?
All individuals who already receive Social Security benefits are automatically enrolled in Original Medicare (Parts A and B) when they reach the age of 65. People turning 65 who are not collecting Social Security need to enroll themselves during their Initial Enrollment Period.
People on disability are automatically enrolled in Original Medicare (Parts A and B) after receiving Social Security Disability Income (SSDI) for 24 months. Get more information about enrolling in Medicare due to disability.
If you have Lou Gehrig’s Disease (ALS), you are automatically enrolled in Original Medicare (Parts A and B) the first month you start to receive SSDI.
People with ESRD three months after dialysis begins or after a kidney transplant. Contact Social Security at 1-800-772-1213, TTY 1-800-325-0778, 7 a.m. to 7 p.m. local time, Monday through Friday for more information.
Know the basics before you enroll in Medicare. If you need help, contact your State Health Insurance Assistance Program (SHIP) for free counseling services.
For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.
When can I Sign up for Part A & Part B, Medicare.gov, February 18, 2016