An overview of Medicare Part A

 

Medicare Part A insurance helps pay for medically necessary care—care for an illness or medical condition—that involves an inpatient stay in the hospital. Part A also helps pay for a stay in a skilled nursing

Nursing care that should be provided only by a licensed nurse.

facility as a follow-up to a hospital stay, hospice care for the terminally ill and some skilled home health care
In Original Medicare, skilled nursing care and therapy, such as speech therapy or physical therapy, provided on a part-time or intermittent basis to those who cannot leave the home.
for those who cannot leave their homes. And it helps pay for some blood transfusions.

What doctors or health professionals can you see?

You can choose any qualified provider in the United States who has been accepted by Medicare and who is accepting new patients. Because Part A offers the same benefits throughout the United States, you are not limited to a particular state or region for your care.

Medicare Part A costs

Medicare Part A premium

Medicare Part A is free if you or your spouse made payroll contributions to Social Security for at least 10 years (40 quarters).

If you otherwise qualify for Medicare but neither you nor your spouse contributed to Social Security for at least 10 years, you’ll pay a monthly premium of up to $451 per month in 2012.

Important: If you don’t qualify for no-premium Part A benefits, and you don’t enroll in Part A when you first become eligible for Medicare, your Part A premium could be higher.

Medicare Part A cost sharing

Medicare Part A deductible

Before Part A begins paying a share of your costs, you must first pay a deductible. In 2012, your Part A deductible is $1,156. You’ll pay this deductible for each hospital stay, subject to certain limits.

Medicare Part A copay

You pay a copay after you have stayed in the hospital or in a skilled nursing facility a certain number of days. Here are the Part A copays for 2012:

  • For hospital stays, you’ll pay $289 per day for days 61 through 90, and $578 per day for days 91 through 150.
  • In a skilled nursing

    Nursing care that should be provided only by a licensed nurse.

    facility, you’ll pay $144.50 for days 21 through 100 that you stay.
  • You’ll also pay a copay of up to $5 for each outpatient drug prescription you receive in hospice care.

Medicare Part A coinsurance

You will pay a small coinsurance payment if you use inpatient respite care for hospice patients.

What is Original Medicare - Parts A & B

<span style="font-size:10px">View Decision Guide</span>

This simple chart shows you how the different parts of Medicare work together.

View Decision Guide

Which Medicare plan is right for you?

Original Medicare (Parts A & B)

A federal health insurance program for people 65 and older, and for those younger with a qualifying disability or special circumstances.

Part A

Medicare Part A

Helps cover hospital stays and skilled nursing services, plus other skilled care—including hospice care.

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Part B

Medicare Part B

Helps pay for doctor visits and other outpatient services, like lab tests and diagnostic screenings.

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Optional add-ons to Original Medicare

Original Medicare doesn't cover everything and it doesn't include prescription drug coverage. You may want a Medicare plan offered by private insurance companies to fill the gap:

Part D

Part D (Prescription Drug Plan)

Plan costs, drugs covered and pharmacy choices vary.

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Medicare Supplement

Medicare Supplement Insurance Plan (Medigap)

Pays for some of the costs Original Medicare (Parts A and B) does not play. Benefits vary. You must have Original Medicare to apply for a Medicare supplement insurance plan.

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OR

Medicare Advantage (Part C)

Costs and benefits vary by plan and location.

Part C

Medicare Advantage

Includes the same coverage you would get with Original Medicare and may include extras like vision, hearing and dental care, as well as gym memberships, often for no additional cost. Most plans include prescription drug coverage. You must be enrolled in Original Medicare and continue to pay your Part B premium.

Part A + Part B + Part D + Extras

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Included Additional Add-Ons to Medicare Advantage


Vision

Dental

Fitness

Optional add-ons to Medicare Advantage

Not all Medicare Advantage plans offer prescription drug coverage. If the Medicare Advantage plan you're interested in does not include drug coverage, you may choose to switch to a Medicare Advantage plan that offers drug coverage. Some Medicare Advantage plan types (PFFS plans) allow members to enroll in a standalone Part D prescription drug plan, as well.

Part D

Part D (Prescription Drug Plan)

Plan costs, drugs covered and pharmacy choices vary.

Learn More