Medicare Part A Coverage

Medicare Part A coverage is the most essential part of the Medicare program. Medicare Hospital coverage focuses on providing Medicare recipients with relief from the most expensive parts of medical care. Part A covers inpatient Hospital care and skilled care in nursing facilities. Coverage also extends to Hospice care and some home health care services. Part A does not provide coverage for unskilled care or long-term care.

Part A is unique in the Medicare program in that most people will not be required to pay a premium to receive care. Anyone who has paid FICA taxes for at least 40 quarters (10 years) will have their Medicare Part A premiums waived. Individuals who do not meet this requirement can still get Part A but they will have to pay a monthly premium. Individuals with between 30-39 quarters of Medicare covered employment will pay a premium of $248.00 a month. People with less than 30 quarters of employment will pay a premium of $450.00 per month for Part A. For 2011 the deductible for Part A is $1,132.00 for the first 60 days spent in the hospital.

Part A works together with Part B, Medical Insurance. Without Part B Medicare will pay none of your doctor's services. Part A also does not cover prescription drugs, doctor's visits, durable medical equipment (such as walkers and canes) and a variety of other medical needs. These types of services are covered by other Medicare Plans.

Medicare Part A covers most of the costs associated with inpatient hospital stays up to 60 days (after paying your deductible). From 60-150 days Medicare covers a portion of the care but you will pay substantial daily co-pays. You must be formally admitted to the hospital or facility by a doctor's order to qualify for inpatient status. Your status can affect your out-of-pocket expenses so check to make sure you have inpatient status as soon as possible. Part A coverage includes meals, a semi-private room, critical and nursing care, rehabilitation, drugs, wound dressings, blood (usually) and pain medications while you are an inpatient. Medicare coverage extends only to medically necessary care and items. Hospital extras are not usually covered and you could be charged for these things. Provided you also have Medicare Part B, your doctor's services will also be covered.

Skilled nursing facility care is covered as long as you have a doctor's order for daily skilled care and have spent at least 3 days in the hospital (not including the discharge day). Medicare does not pay for custodial care. Skilled nursing care is covered for the first 20 days. After this you will pay a co-pay of $141.50 a day. Medicare Part A also covers a portion of home heath services including physical therapy, occupational therapy and skilled nursing care for homebound patients.

Hospice care for dying patients with six months or less left to live is included in Part A coverage. A doctor must file an order stipulating that you are expected to live less than six months. Medicare Hospice coverage includes almost everything you might need and care can be administered at home or in a facility using a Medicare-approved provider.

Auntie Lou says, "Why would anyone want Hospice unless they were headed for the beyond? Seems to me that a doctor's order to get care before you go to heaven is a bit much."

In summary, Medicare Part A coverage is designed to pay for the most expensive parts of medical care. The coverage includes hospital services, inpatient care, skilled nursing care, skilled home care and hospice care. Medicare Part A works in conjunction with Part B to cover most medically necessary items and services.