Medicare is just complicated. With changing premiums, multiple parts, supplemental options, and changing regulations, Medicare is difficult to keep up with. Our Medicare representatives at Delta Benefits Group are here to help you understand the ins and outs of your Medicare coverage. It’s our mission to help you get the most out of your plan, so we’ve started writing in-depth articles to explain all aspects of Medicare. This week, we’re covering everything you need to know about Medicare Part A.
If you have remaining questions, please give us a call at (901) 460-7220, send us an email at email@example.com, or fill out the contact form on this page. Note that our Medicare consultations are always free of charge.
What Does Medicare Part A Cover?
Many people wonder what is covered under Part A. Medicare Part A, sometimes called “hospital insurance,” covers anything involving in-patient hospital care. This includes all of the following services:
In-patient hospital stays - Part A covers care received when you are admitted to the hospital. Part A covers you for up to 90 days in the hospital each benefit period, plus 60 lifetime reserve days. Psychiatric hospital stays are also covered by Medicare up to 190 lifetime days.
In-patient surgery - Surgery performed while you are in the hospital is covered under your Part A coverage.
Skilled nursing facilities (SNF) care - To qualify, you must have spent a minimum of 3 consecutive days in in-patient hospital care, within 30 days of admission to SNF care. Medicare will pay 100% for the first 20 days in SNF care. From days 21 - 100, you’ll pay $185.50 per day.
Hospice care - If your doctor determines you are terminally ill, you can elect to use this coverage. Hospice is covered for as long as your healthcare provider determines you need care.
Lab tests - Labs taken while you are in the hospital in in-patient care are covered under Part A.
Home health care - Part A and/or Part B covers this.
If you have specific questions about what does original Medicare cover, see our FAQ page, where we discuss Part B, as well.
How Much Does Part A Cost?
Usually, Medicare Part A is free. You may have heard this called “Premium-Free Part A.” If you and your spouse paid taxes during a specified period of time while working, you won’t pay for Original Medicare (Part A and B). However, some people will have to pay, depending on how long each spouse paid Medicare taxes. The cost in 2021, depending on how much you paid in taxes, is set at:
If you worked 40 quarters, paying Medicare taxes, your Medicare Part A is free
If you worked between 30 and 40 quarters, you will pay $259 per month for Part A
If you worked fewer than 30 quarters, you will pay $471 per month for Part A
Will I Have to Pay Deductibles or Copays?
Keep in mind that Medicare does not usually pay the full cost of your care, and you will likely be responsible for some portion of the cost-sharing (deductibles, coinsurances, copayments) for Medicare-covered services. As of 2021, you will be responsible for a deductible of $1,484 per benefit period if you are hospitalized. A benefit period begins the first day you are in the hospital and ends after you have been out for 60 days. For the first 60 days, you are in the hospital, you will have a $0 copay. After 60 days, your copay will be $371 per day. After 90 days in the hospital, your copay will increase to $742 per day until day 150. The last 60 days (days 91 - 150) are considered lifetime reserve days. You are only giving 60 of those days, and once they are used, you are on your own. This is when supplemental coverage comes into play, and it’s one reason we highly recommend it.
When & How to Apply for Medicare Part A?
For most people, Part A enrollment is automatic. However, some people will have to manually enroll, depending on their social security situation. There is a 7-month period for initial enrollment (IEP) into Original Medicare, which depends on when your 65th birthday is. IEP begins 3 months before the month of your 65th birthday, includes your birth month, and includes the 3 months following the month of your 65th birthday. Your coverage will begin on day 1 of the month you turn 65. If your birthday falls on the first day of the month, your coverage will begin on day 1 of the previous month.
There may be some special circumstances, including disability which allows 24 months for sign up. Your Medicare representative can help with these explanations.
Wondering how to apply for Medicare if you’re not automatically enrolled? There are 4 ways to sign up:
Visit your local social security office - note that this is not an option this year due to the COVID-19 Pandemic
Sign up online at ssa.gov/medicare/
Call SSN at 800-772-1213 and apply on phone
Call Delta Benefits Group, and we can help you sign up online; you can reach us at (901) 460-7220. You can also email us at firstname.lastname@example.org
Should I Talk to a Medicare Representative?
A Medicare representative can help you better understand the ins and outs of your Medicare and help enroll you. If you would like some assistance signing up, finding the right supplemental plans based on your specific needs, or you have questions about your Medicare, you can call our experience and trusted Medicare representatives, and we will answer your questions free of charge. You can reach us at (901) 460-7220. We look forward to helping you understand your health insurance.
Do you have questions about other parts of Medicare? Check out our frequently asked questions page.