When being faced with the transition into Medicare, the choices can seem overwhelming. Different types of Medicare plans help pay for such things as inpatient hospital care, outpatient services, doctors visits, prescription drugs, home health, the list goes on and on depending on what health plan you choose. Have no fear! As complicated as it all may sound, once you make yourself familiar with all the parts of Medicare, deciding what is best for you and your healthcare needs can be a piece of cake!
Medicare Part A
When you apply for Medicare, you will automatically be enrolled in Part A. Part A is part of
Original Medicare and is a fee for service program that is offered directly through the federal
- Original Medicare is often time referred to as Traditional Medicare or Fee-For-Service Medicare.
- Under Original Medicare the government pays directly for the health care services you receive that are covered under that plan. Medicare Part A is your Hospital Insurance Plan.
Medicare Part A Covers:
●Inpatient Hospital Care: for up to 60 days each benefit period, plus 60 lifetime reserve days in a general hospital. It also covers up to 150 lifetime days in a Medicare certified specialty psychiatric hospital.
●Skilled Nursing Facility Care (SNF): Coverage up to 100 days per benefit period. To qualify, you must have been in the hospital for 3 consecutive days in the 30 days before admission, and be in need of skilled nursing services 7 days a week, or physical, occupational, or speech therapy services 5 days a week.
●Home Health Care: For up to 100 days. To qualify you must have been admitted to the hospital for 3 consecutive days in the 14 days before receiving care and be homebound.
●Hospice Care: For as long as your doctor certifies that you need care. To qualify, a doctor must certify that you are terminally ill and have a life expectancy of 6 months or less.
When it comes to premiums for Medicare Part A, you most likely will not have to pay if you or your spouse have worked and paid payroll taxes for 40 quarters, which is 10 taxable years. If you are a U.S. Citizen or resident who has not worked enough quarters, and you cannot qualify through a spouse, you may be able to buy Part A coverage. You must meet your deductible each benefit period before Medicare will cover any of your hospitalization costs. The Part A deductible for the 2016 plan year is $1,288. Part A pays about 80% of your Medicare approved amount, which is the cost that Medicare determines is reasonable for the care you have
For more information on Medicare, its parts, enrollment deadlines, plan costs, etc visit our Medicare Resource Library.