Medicare Part A is also known as “hospital insurance” in Medicare terms. Normally Medicare Part A covers five main things:
Inpatient care in a hospital
You’re admitted to a hospital for inpatient care after you receive an official order from your doctor which says you need inpatient care for treatment of your injury or illness.
Skilled nursing facility care
Covers skilled nursing care provided in a Skilled Nursing Facility (SNF) in certain conditions for a short term basis if you meet certain criteria.
Inpatient care in a skilled nursing facility (SNF) (not custodial or long-term care)
Nursing homes are not covered by Medicare if that care is custodial. Medicare may cover a SNF if it is deemed medically necessary for you to have skilled nursing care such as changing your bandages.
You can get hospice care if you meet certain conditions: meaning you’re terminally ill and have a life expectancy of 6 months or less, accept palliative care for comfort, not treatment of your illness, you agree to hospice care instead of receiving other Medicare benefits.
Home health care
In home health services such as intermittent skilled nursing care, physical therapy, occupational therapy, speech pathology, medical social services or intermittent home health aide services.
What Determines Medicare Part A Coverage?
Eligibility for Medicare Part A coverage is determined by 3 main factors:
Federal & State law
National coverage decisions made by Medicare about whether something is or is not covered by Medicare
Local decisions made by companies in each state that process claims for Medicare. These companies may decide whether something is medically necessary and should be covered in a certain area.
What Else Should I Know About Medicare Part A?
In order to be eligible for a Medicare Supplement Insurance Plan, you need Medicare Part A and Part B first. Once you have enrolled in Medicare Part A & B, you’ll select the Medicare Supplement Insurance Plan that is right for you.
Need help navigating your Medicare and understanding the Medicare options available to you? We’re here to help. Our agency has dedicated ourselves to helping Medicare eligible customers understand their Medicare Insurance and helping them find a supplement plan that works for them. Please give us a call.
Frequent Asked Questions About Medicare
Can I keep all my same doctors when I’m on Medicare?
Most likely, yes. You need to ask your current doctor if he or she accepts Medicare.
Do I need to enroll in Part “A” and Part “B” of Medicare?
Part “A” is typically in place, and a paid-up benefit when you turn 65. Part “B” is not, unless you have enrolled in Social Security prior to age 65. If you have not filed to receive Social Security benefits, then you need to proactively enroll in Part “B” benefits and begin paying for them.
Can my spouse be on my Medicare plan?
No. For Medicare insurance, you need an individual plan. If your spouse is over 65, then he or she can enroll in their own Medicare plan. If you need help finding the best Medicare plan for you or your spouse, call us.
Can I keep my employer’s health insurance coverage if I am 65?
It depends. If you work for a company that has over 20 employees and you are going to continue to work, then you can keep your current employer coverage. However, you should discuss your options with a Medicare expert.
What Medicare plan do I need for home health care?
Medicare Part A covers home health care. To find out if Medicare covers what you specifically need, contact a Medicare expert at our agency.
What Medicare plan covers hospice care?
Medicare Part A.
Does Medicare Part A cover Emergency Room visits?
If you are admitted into the hospital as an inpatient then Part A most likely covers you. You will be responsible for your deductible and copayment. If you are not admitted, most likely you aren’t covered. Call Dave Silver Insurance in Tampa for all your questions about Part A coverage.