A is a coverage of inpatient hospital insurance and part B is the coverage of outpatient medical insurance. Medicare part A covers most of all facilities while admitted in the hospital like skilled nursing facility, doctor visits, etc. This health insurance is provided by the federal government to all USA residents who are living there for at least 5years without any interruption. If you are at the age of 65, you are eligible for Medicare part A and automatically enrolled by the system. Before the age of 65, if you have a very serious disability like amyotrophic lateral sclerosis (ALS) or end-stage renal disease (ESRD) you may enroll yourself in the plan.
Coverage of Medicare part A
There are lots of services covered by Medicare part A which are mentioned below.
- Inpatient hospital care
- Skilled nursing facility
- Nursing home care
- Hospice care
- Home health services
Inpatient hospital care:-
When the patients are admitted to the hospital, medicare part A helps to cover some of the burdens of the patient parties. They provide meals,semi-private rooms, nursing services, medications that are needed for your treatments. This part A also covers some inpatient services which is
- Acute care hospitals
- Inpatient rehabilitation facilities
- Critical access hospitals
- Mental health care
- Long-term care hospitals
- Participation in a clinical research study
In this part, you don’t get coverage of blood, private nurses, private rooms, and personal care items.
Skilled nursing facility:-
If you are admitted to a hospital there are few nursing services provided by medicare under part A. If you have several injuries and illnesses after 3days of observation you may receive this service. In these services include:-
- Semi-private room
- Skilled nursing services
- Medical social services
- Rehabilitation services, if they are medically necessary to treat your illness
- Ambulance transportation to the nearest provider if needed services are not provided at the SNF
- Medical supplies and equipment used in SNF
- Medications received while in SNF care
- Dietary counseling
Medicare part A does not cover long-term medical services as well as physical therapy or intravenous drugs.
Nursing home care:-
It is a part of a skilled nursing facility. If you receive the skilled nursing facility (SNF) then you are eligible for it. It will help you to do daily living tasks like dressing, bathing, etc.
- Hospice care:-
If you have a terminal illness and your doctor gives a certificate on it then you are eligible for this care. The main reason for this care is to comfort the patient as much as they can. In this case, patients generally live six months or less.
Some of the services included in this care such as
- Doctor services
- Nursing care
- Pain relief medications
- Durable medical equipment
- Medical supplies
- Social services
- Homemaker services
- Hospice aide services
- Physical and occupational therapy
- Short-term respite care
- Short-term inpatient care
- Dietary counseling
These facilities are generally received from the patient’s home. You can abort these services at any time. Although you have to need special permission to receive this service.
Home health services:-
It is for limited time services which are given by medicare part A. It is a homebound health services service provided by a Medicare-certified home health agency when you are eligible for it. Which includes
- Part-time or intermittent skilled nursing care
- Durable medical equipment, when ordered by your doctor
- Speech-language pathology services
- Physical therapy
- Occupational therapy
- Part-time or intermittent home health aide services
- Medical social services
As you can see that it is a homebound therapy then you need to qualify some of their criteria to receive this kind of service.
Costs of Medicare Part A
For some people medicare, A will be completely free of cost without any premium. If you’re working under a Medicare-covered place for at least 40 quarters or 10 years and paying all the medical taxes while working you can’t spend any penny for medicare part A enrollment. Besides that, there are lots of other coverage where you need to spend money on your own. It has also the facility of deductibles, copayments, and/or coinsurance, which may change every year. The cost varies depending on the plan.
Time for medicare part A enrollment
Some people automatically enlist their name for the plan but others have to enroll themselves manually.
If you are not enlisted your name after being eligible for the plan you may pay the late enrollment penalty once after your sign-up.
Initial Enrollment Period for Medicare Part A
If you receive the benefits from the Railroad Retirement Board (RRB) or Social Security retirement benefits then after your age of 65 you are eligible for the Medicare part A plan and enrolled automatically. This period starts from the first day of the previous three months of your birth month of the year you turn 65, including your month it ends up the last day after 3months of your birth month, And also get a Medicare card via mail. This 7 months (3+1+3) is called the initial enrollment period. If you are enrolled automatically when you get your Medicare benefits before 3months of your 65. Your medicare part B also starts from this time.
If you are not receiving any kind of benefits from the government then you have to manually enroll yourself during the initial enrollment period.
If you are not able to enroll yourself for medicare part A and B you have to receive your Social Security disability benefits ( if you are under 65 or disable ) for 24 months. After this period you have to be able to receive the plan.
If you have the end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS) then you enroll automatically even if you’re not 65.
General Enrollment Period for Medicare Part A
In case you miss enrolling yourself during the initial enrollment period you can also get a chance to enroll yourself during the general enrollment period. January 1 to March 31 is called the general enrollment period every year. If you enrolled yourself during this time then you don’t have to pay any late enrollment penalty for the plan. After completing your procedure of enrollment you can enjoy your plan from 1st July.
Special Enrollment Period for Medicare Part A
If you or your spouse is not eligible for the plan because of volunteer service in a different country for some reason and you want to enroll yourself for the plan then you may enroll yourself during this special enrollment period. It is an eight-month period that starts right after your other coverage ends. If your previous coverage ends during the initial enrollment period then you can simply enroll that time without any hesitation. If you qualify for a special enrollment period then you don’t have to pay any kind of late enrollment penalty. Your coverage will start right after your enrollment. If you want to know more then must visit Medicare Part A premiums and other costs details.