Medicare Part A, also known as Hospital Insurance, is one of the four parts of Medicare, a federal health insurance program for individuals 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant). Medicare Part A covers:
- Inpatient hospital stays
- Skilled nursing facility care
- Hospice care
- Home health care
- Nursing home care
What Are the Costs of Medicare Part A?
Most people don’t pay a monthly premium for Medicare Part A, but some may have to pay a deductible, coinsurance, and copayments:
- Premium: $0 (most people), $278 or $505 (depending on the length of time you or your spouse paid Medicare taxes)
- Deductible: $1,632 per benefit period
- Coinsurance:
- Days 1-60: $0
- Days 61-90: $408 per day
- Days 91-150: $816 per day (lifetime reserve days)
- Copayments:
- Skilled nursing facility care: $0 (first 20 days), $204 per day (days 21-100)
- Hospice care: $5 copayment for each prescription drug
How to know your eligibility for Medicare Part A
You’re eligible for Medicare Part A if:
- You’re 65 or older
- You’re under 65 with certain disabilities
- You have End-Stage Renal Disease (ESRD)
- And you’re a U.S. citizen or permanent resident
Automatic Enrollment
If you’re already receiving Social Security benefits, you’ll be automatically enrolled in Medicare Part A on the first day of the month you turn 65. If you’re under 65 and receiving Social Security Disability Insurance (SSDI) benefits, you’ll be automatically enrolled in Medicare Part A after 25 months of benefits.
Applying for Medicare Part A
If you’re not automatically enrolled, you can apply for Medicare Part A online through the Social Security Administration (SSA) website, by phone, or in person at a Social Security office. The initial enrollment period starts three months before your 65th birthday and ends three months after.
Free Medicare Part A
Most people don’t pay a monthly premium for Medicare Part A. You qualify for free Medicare Part A if:
- You’re receiving retirement benefits from the Railroad Retirement Board (RRB) or Social Security Administration (SSA)
- You’re eligible for retirement benefits but haven’t filed yet
- You have Medicare-covered government employment or a spouse with it
- You have ESRD
How to Apply for Medicare Part A
You can apply for Medicare Part A online, by phone, or in person at a Social Security office. You’ll need to provide proof of age, citizenship, and residency.
Medicare Part A Enrollment periods
There are several enrollment periods for Medicare Part A:
- Initial Enrollment Period (IEP): This is the three-month period before your 65th birthday, the month of your birthday, and the three months after.
- Annual Election Period (AEP): This is the period each year when you can change your Medicare coverage options.
- Special Enrollment Period (SEP): This is a special period that allows you to enroll in Medicare Part A if you experience certain life events, like losing employer-based coverage.
How to find out if Medicare covers what you need
Talk to your doctor or other health care provider about why you need certain services or supplies. Ask if Medicare will cover them. You may need something that’s usually covered but your provider thinks that Medicare won’t cover it in your situation. If so, you’ll have to read and sign a notice. The notice says that you may have to pay for the item, service, or supply.
Medicare Part A is an essential part of the Medicare program, covering inpatient hospital stays, skilled nursing care, hospice, and home health care. Understanding the costs and eligibility requirements can help you make informed decisions about your healthcare coverage. If you have questions or need assistance, you can visit the Medicare website or contact a Medicare representative.
