Like a jigsaw puzzle, Medicare is made of different pieces that fit together to provide health coverage for Medicare beneficiaries. The various pieces of Medicare coverage are Medicare Part A, Part B, Part C, Part D, and Supplemental. Each piece covers different types of benefits, and trying to understand all the parts at once can be a daunting task. So, here’s a look at what Medicare Part A covers.
What Medicare Part A covers
Medicare Part A is hospital insurance. It covers some of the cost of inpatient care services received in hospitals, which can include:
- Inpatient care in a hospital
- Skilled nursing facility (SNF) care that is medically-necessary care (like changing sterile dressings)
- Hospice care for patients with a terminal illness with an estimated six months or less to live (patients must meet a specific set of conditions to qualify for hospice care)
- Some home health services when certain conditions are met, and a doctor has certified the patient to be homebound
Note about nursing homes: Most nursing home care is custodial care (bathing, dressing, using the bathroom, and eating). Medicare doesn’t cover custodial care if it’s the only care needed. If it is medically necessary for a patient to have skilled nursing care (like changing sterile dressings), Medicare Part A may cover care in a skilled nursing facility, as noted above.
Who is eligible for Part A?
Most people are eligible for Part A automatically when they turn 65. Part A is available at no cost to people who have worked, or whose spouses have worked, for at least ten years and have paid Medicare taxes through their employers.
When should I enroll in Part A?
While most people are enrolled automatically in Medicare Part A, many people will need to enroll on their own. This could include people who work past age 65 and aren’t getting their Social Security benefits or those who qualify for Medicare because they have End-Stage Renal Disease.
The times when you can sign up for Medicare Part A include:
- During your Initial Enrollment Period, which is when you turn 65 or first become eligible for Medicare
- During the General Enrollment Period January 1 – March 31
- During a Special Enrollment Period (SEP) when certain events happen in your life, like if you move or lose other insurance coverage
Part A late-enrollment penalty
If you are required to enroll in Part A on your own and don’t sign up when you are first eligible, your monthly premium could go up as much as 10 percent for twice the number of years that you delay. A delay from one month or one year will result in the same 10 percent penalty. For example, if you put off signing up for Part A for two years, you will pay a higher premium for four years.
What Medicare doesn’t cover
Medicare doesn’t pay for everything. If you need services Medicare doesn’t cover, you’ll have to pay for them yourself unless you have other insurance or you’re in a Medicare health plan that covers those services.
Learn more about how Medicare works. Visit ibxmedicare.com/educate.
Material ID: Y0041_HM_85295_2020
Website last updated: 06/29/2020