Medicare Part A

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

Here at Boomer Benefits, we tell our clients to think of it as “room and board” in the hospital. It’s going to cover a semi-private room with a bed for you, and all your regular meals while you are there. It will cover medications furnished to you by the hospital and any necessary lab services or medical supplies.

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.

What Does Medicare Part A Cover?

In addition to Medicare hospitalization coverage, Medicare Part A also covers post-hospital skilled nursing and short-term post-hospital home health care, as well as hospice services which may include palliative care, DME, counseling, and social services. Part A also provides for some home health care services received in the hospital or immediately following an inpatient stay. This includes skilled nursing care, medical social services, and physical therapy. Home health aid services are generally only covered when skilled nursing is also occurring.

Medicare does NOT cover long-term care, such as extended stays in a nursing home. However, there are some things that you might think would fall under Part A but sometimes fall under Part B, such as outpatient surgeries. When it comes to determining if something is inpatient vs outpatient, it’s always a good idea to consult your Medicare insurance broker for guidance.

Enrolling in Medicare Part A is automatic for people already taking Social Security income benefits. When this happens, they will open their mailbox 2 – 3 months before they turn 65 and find their card waiting for them.

People on Medicare should keep an eye on their mail for the Medicare card. It is a red, white and blue card printed on heavy card stock. Once received, it is okay to laminate the card so that it will stay in good shape over time.

If not already receiving Social Security income benefits or Railroad Retirement income benefits, then active sign up for Part A is needed at age 65. This can be done at the Social Security website.

What is my Medicare Cost-sharing under Part A?

As a Medicare beneficiary, you are responsible for a portion of your hospital and medical costs. Each year, the Centers for Medicare & Medicaid Services (CMS) sets the amount you will pay for your Part A deductible and coinsurance.

In 2022, you will pay:

A $1,556 deductible for each inpatient hospital stay when you have not been in the hospital during the previous 60 days.

$389 per day for days 61 – 90 of a consecutive hospital stay

$778 per day for days 91 – 150 of a consecutive hospital stay

Any and all costs past your lifetime reserve days.

What are lifetime reserve days?

If you have a Medigap plan, you will have 60 lifetime reserve days. These can be used if you need to stay in the hospital for more than 90 consecutive days.

For example, if your first hospital stay lasts 100 days, then you would have used 10 of your lifetime reserve days. If you have another hospital stay within the next year that lasts 120 days, then you would have used a total of 30 (10 + 20) of your lifetime reserve days.

Once you have used all of your lifetime reserve days, you will need to pay for all Part A costs starting on day 91 for any future hospital stays lasting longer than 90 days.

Skilled-nursing facility costs

For skilled nursing facility stays, Medicare covers the first 20 days. Your daily copay in 2022 for days 21-100 will be $194.50. Fortunately, both Medigap policies and Part C Advantage plans will help cover these costs. Either type of plan will help you to significantly reduce your financial exposure related to skilled nursing facility costs.

Common Questions

Q: How do I sign up for Medicare Part A only?

A: If you have creditable coverage, you can delay Medicare past 65. However, many people will enroll in Part A for secondary hospital coverage. You can apply for Part A only through the Social Security Administration website.

Q: What is the difference between Medicare Part A and Part B?

A: Medicare Part A is inpatient hospital coverage, while Part B covers outpatient medical services.

Q: How much is Medicare Part A?

Many people will have a $0 monthly premium for Part A if they’ve worked at least 10 years in the U.S. However, if you don’t qualify for premium-free Part A, you could pay as much as $499 for Part A.

To get help with your Medicare insurance needs or learn more about Medicare hospital coverage, call our insurance experts at (317)-536-8565 for a FREE consultation!