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Medicare Part A

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What is Medicare Part A Insurance?

Medicare Part A is hospital insurance. Part A generally covers inpatient hospital stays, skilled nursing care, hospice care, and limited home healthcare services. You typically pay a deductible and coinsurance, and/or copayments.

What does Medicare Part A Insurance cover?

Medicare Part A covers the following services:

  • Inpatient hospital care: This is care received after you are formally admitted into a hospital by a physician. You are covered for up to 90 days each benefit period in a general hospital, plus 60 lifetime reserve days. Medicare also covers up to 190 lifetime days in a Medicare-certified psychiatric hospital.
  • Skilled nursing facility (SNF) care: Medicare covers room, board, and a range of services provided in an SNF, including administration of medications, tube feedings, and wound care. You are covered for up to 100 days each benefit period if you qualify for coverage. To qualify, you must have spent at least three consecutive days as a hospital inpatient within 30 days of admission to the SNF, and need skilled nursing or therapy services.
  • Home health care: Medicare covers services in your home if you are homebound and need skilled care. You are covered for up to 100 days of daily care or an unlimited amount of intermittent care. To qualify for Part A coverage, you must have spent at least three consecutive days as a hospital inpatient within 14 days of receiving home health care. (Note: You can get home health care through Medicare Part B if you do not meet all the requirements for Part A coverage.)
  • Hospice care: This is the care you may elect to receive if a provider determines you are terminally ill. You are covered for as long as your provider certifies you need care.
    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.

Am I eligible for Medicare Part A Insurance?

Starting at 65 years of age, most people are eligible for Medicare Part A coverage. To be eligible, a person must be a citizen of the U.S. or have been a legal resident for 5 consecutive years.

People below the age of 65 years may meet eligibility requirements based on their medical status.

Medicare Part A eligibility requirements for people under 65 years of age include those collecting Social Security Insurance (SSI) or Railroad Retirement Board (RRB) for 24 months due to a disability.

There are also special rules for people under 65 years of age who have either end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS). People with ALS can receive Medicare Part A the first month after qualifying for SSI benefits.

The rules for people with ESRD are more complicated. The waiting period varies according to how long they have been on dialysis, with eligibility beginning after the third month following dialysis. However, if a person has completed self-dialysis training, eligibility starts during the first month.

Coverage will also kick in during the month of a kidney transplant or earlier if a person requires hospitalization 2 months before a kidney transplant to prepare for the procedure.
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