Medicare benefits allow elderly and disabled individuals to access the health care benefits they need to afford vital treatment. Original Medicare is the core Medicare package and features two components, Part A and Part B. This is what you can expect your Part A benefits to cover.
What Is Part A?
Medicare Part A is the component of Original Medicare that pays for hospital health care costs. Part A benefits kick in whenever you are admitted to a hospital that accepts Medicare after an official doctor’s order states that you need inpatient care to treat your condition. In some cases, a Utilization Review Committee may need to approve your stay while you are in the hospital in order for your benefits to apply.
Hospital insurance covers three major types of care, inpatient hospital care, skilled nursing facility care, and treatment in long-term care hospitals. These are some things to know about each type of care:
Inpatient Hospital Care
Your Part A benefits will cover the care you receive in acute care hospitals, critical access hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, and long-term care hospitals. If you have Part B coverage as well, you should have 80% of doctor’s services received in the hospital covered as well. This typically does not include the cost for a private room, private-duty nursing, or personal care items.
Skilled Nursing Facility Care
If you need health care that requires skilled nursing or therapy to treat your condition, Medicare should help you cover associated costs. Some of these costs include:
- Physical therapy
- Occupational therapy
- Speech-language pathology services
- Medical social services
- Dietary counseling
- Semi-private rooms
In order for Medicare to cover skilled nursing facility care, you must have treatment prescribed by your doctor after a qualifying hospital stay and your care must be carried out by a Medicare-certified skilled nursing facility.
Long-term Care Hospitals
Care in a long-term care hospital won’t require you to pay a new deductible if you have been charged a deductible for care you got in a prior hospitalization during the same benefits period. Remember, long-term care hospitals are best at treating patients who have exceeded 25 days of inpatient hospitalization. After you finish treatment in the long-term care facility, you may be transferred to a skilled nursing facility or custodial care facility, depending on the nature of your condition.
Medicare Part A Costs
Medicare Part A can be purchased but is also available premium-free for individuals who have paid Medicare taxes for at least 40 quarters. Even if you qualify for premium-free Part A benefits, you will have to pay out-of-pocket costs, like coinsurance and deductibles. To mitigate some costs, you can invest in Medicare Supplement Insurance. Contact a professional to learn more.