Medicare Part A Coverage
What is Medicare Part A?
Medicare Part A is hospital insurance. It helps pay for medically necessary care you receive as an inpatient. You are an inpatient when you are formally admitted by doctor’s order to the hospital or a skilled nursing facility. Part A also helps pay for some home health care and for hospice care.
What's covered under Medicare Part A?
A semi-private room
Lab tests, X-rays, and radiation treatment as an inpatient
Your hospital meals
Operating room and recovery room services
Skilled nursing care Nursing care that should be provided only by a licensed nurse.
Some blood transfusions in a hospital or skilled nursing facility
Care on special units, such as intensive care
Rehabilitation services, such as physical therapy received through home health
Drugs, medical supplies, and medical equiptment as an inpatient
Skilled health care in your house, if you cannot leave your home and only need part-time care
Care to manage symptoms and control pain for the terminally ill
What's not covered under Medicare Part A?
Medicare Part A does not help with the cost of:
- Most doctor services you receive in the hospital. Doctor services are covered under Part B.
- Personal services such as a television or telephone in your room.
- Custodial care such as help with eating, bathing or dressing.
What doctors or health professionals can you see?
You can see any qualified provider in the United States who accepts Medicare assignment Term used to indicate a doctor’s agreement to take the Medicare-approved amount paid for a service as full payment. If your doctor accepts assignment, your share is limited to your coinsurance payment, usually 20% of the Medicare-approved amount. and who is accepting new patients. You can receive care in any state or region. Original Medicare Part A offers the same benefits throughout the United States.
What are the coverage limits with Medicare Part A?
Medicare Part A helps pay for up to 90 days of hospital or skilled care during one benefit period In Medicare Part A, a benefit period begins the day you go into a hospital or skilled nursing facility. It ends when you have been out for 60 days in a row. You may be in the hospital more than once during one benefit period. There is no limit on the number of benefit periods that Medicare will cover. Part A charges a deductible for each benefit period. . Starting with day 91, you can begin to draw on your lifetime reserve days. Lifetime reserve days are like a bank account of extra hospital days covered by Medicare. You have 60 extra covered days in your account that you can use over your entire life.
Part A helps pay for an unlimited number of skilled home care and hospice care visits. You must meet certain conditions to receive these services.
What is hospice care?
Hospice care is end-of-life care. The purpose of hospice care is to help make the last weeks or months of life as comfortable as possible. It helps support the physical, emotional, social and spiritual needs of the patient and loved ones.
Medicare-approved hospice programs are available in most areas. They offer special teams of professionals who care for the terminally ill in a family home, nursing home or assisted living facility. Hospice services are available 24 hours a day, seven days a week.
A hospice team can include
health care professionals, social workers,
chaplains and trained volunteers.
Medicare pays the entire cost of hospice care. This includes the care providers, drugs to manage symptoms and pain, medical supplies and medical equipment.
Once hospice care begins, Medicare no longer covers treatments intended to cure. But hospice patients can return to Medicare’s curative care services at any time.
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