Medicare
Part A

Part A covers many different things and is one of the most basic levels of Medicare coverage. For most beneficiaries, it is free and an excellent option for health insurance. Though coverage can vary depending on location and provider, some services are covered solely under Part A.

Hospital Inpatient Coverage

Many know of Part A because of its hospital inpatient care coverage. To get inpatient coverage, you’ll need a doctor to verify that your admittance was necessary. The hospital will also need to accept Medicare. Some people may need to get special approval for a hospital stay, but that is rare and only under specific circumstances. For inpatient care, Part A is very inclusive. Meals, a semi-private hospital room, and medication may all be included.

Skilled Nursing Care Facility Coverage

Certain skilled nursing care facilities are covered, but the stay there must meet certain criteria. The admittance to the facility must be short term. For skilled nursing care facility care, the prices go up in two increments depending on the length of the stay. The first day through the twentieth day will not have any payment required. The twenty-first day through the hundredth day will require $176 in coinsurance per day. If the stay extends beyond 100 days, the beneficiary is responsible for paying all costs.

If therapies are needed, Part A will provide coverage, as well as medications and other services necessary for healing. It’s important to note that everything covered under Part A will need to be justified as necessary.

Long-term Care Hospital Coverage

Long-term care hospital admittance is covered through Medicare Part A. It is more expensive than the previous coverage mentioned, but the pricing model is relatively similar. The first 60 days have a deductible of $1,408. After that, days sixty-one through ninety have a $352 coinsurance per day. From day 91, there is a $704 coinsurance that must be paid for each “lifetime reserve day.” Once the beneficiary has used all lifetime reserve days, they are responsible for paying all costs.

Hospice Coverage

Basic hospice care is covered and given free of charge as long as the beneficiary is eligible. They must have proof of terminal illness and be expected to live for or less than six months. Choosing hospice care means forgoing treatment, which could potentially cure illness and, instead, accepting palliative care.

Home Health Coverage

Certain home health services are covered under Medicare Part A. Therapy and part-time nursing assistance are within the realm of coverage and can provide help for families and caretakers.

Part A Specifics

Part A covers many different things, so it can be confusing to understand all of the regulations put into place. Before beginning treatment or scheduling a surgery, you may want to reach out to an insurance provider and ask what your coverage specifically entails. Give us a call, and have your questions answered.