I’ve had a lot of questions come my way about Medicare lately, which is fairly complex. There are a lot of parts and nuances to it. There is Medicare Part A, which we will go over in this article, because it’s in the title. There’s also Part B and Part D, among others. Then there’s original Medicare coverage. There’s also Medicare Advantage plans. Medicare supplement plans sold by private insurance companies exist as well. Rather than attempt to explain all this stuff over and over, I thought I’d write a series of posts about the various parts, coverage options, plan selection options, and anything else that comes to mind.
Let’s get started with Medicare Part A today. Let’s break this down into 3 main topics:
- What does Medicare Part A cost?
- What Medicare Part A coverage do I get?
- When do I sign up for Medicare Part A?
So, what Does Medicare Part A Cost?
Great question! I’m glad you asked. Generally, if you paid Medicare taxes while you were working then Medicare Part A isn’t going to cost you squat (think $0.00/month) if you’re age 65. If you’re required to pay for Part A it can run up to $422/mo. Why would you be forced to pay for it? If you didn’t pay Medicare taxes for fewer than 30 quarters, it will cost you $422/month. If you paid Medicare taxes for 30-39 quarters, you’ll have to cough up $232/month. Get it? If not, don’t sweat it, feel free to reach out to me and we can talk more about it.
Ok, great, but what Does Medicare Part A Cover?
While coverage may differ if you have a Medicare Advantage Plan versus a Medicare Supplement plan, the following is a general outline of what Medicare may cover, under Part A, if you have Original Medicare. While this is not a 100% complete list of everything Part A covers, I think it give us a general outline of the most popular and most used coverage options in Part A.
- Inpatient hospital care:
$1,340 deductible for each benefit period. Days 1-60 you pay $0 coinsurance for each benefit period. Days 61-90 – you pay $335 coinsurance per day of each benefit period. Days 90 and beyond – you pay $670 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime).
- Skilled nursing care:
Medicare covered services include but are not limited to; a semi-private room, meals, skilled nursing care, physical and occupational therapy, some medications, medical supplies and equipment (if used in the facility) and dietary consulting. Patient will be required to pay the following: Days 1-20, you pay $0.00. Days 21-100, you pay $167.50/day coinsurance. Days 101 and beyond, no coverage and you will be responsible for all costs.
- Long-term Care Hospitals:
Generally, you will not have to pay an extra deductible if you’re transferred to a Long-Term Care Hospital. As long as you’re transferred to one directly from an acute care hospital or you’re admitted to a LTCH within 60 days of being discharged from a regular hospital.
When Should You Sign Up For Medicare Part A?
Another great question! You can sign up for Medicare Part A in one of two periods of time:
- During a 7-month window around your 65th birthday or
- During the normal open enrollment time-period each year (Most years it’s generally October 15th until December 7th)
Open enrollment is pretty self-explanatory. Let’s focus on the 7-month window.
- Begins 3 months before the month you turn 65
- Includes the month you turn 65
- Ends 3 months after the month you turn 65
Before we finish here, there’s one more thing I fee compelled to disclose. The Medicare Part A late enrollment penalty. If you do not sign up for Part A during a certain period of time after your 65th birthday you may be assessed a penalty. Don’t get all worried if you’re over 65 right now there are some special circumstances that may come into play and save you from the penalty. My next post will go into greater depth about Medicare penalties, how they’re assessed, how much they are, and how to avoid them.
Okay. That’s it, I’m done.
All information was retrieved from www.medicare.gov. Information is deemed to be obtained from a reliable source. Nothing in this blog post should be considered advice regarding Medicare coverage of any kind. Please consult a Medicare representative for any advice or questions regarding coverage and/or price.