Medicare Part A

Medicare Part A

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Medicare Part A

Original Medicare is divided into two parts – Part A and Part B
Medicare Part A covers inpatient hospital care, skilled nursing facility care, home health care and hospice care.
Inpatient hospital care is covered when each of these are true:
  • You are admitted to a hospital, as an inpatient, after an official doctor’s order stating you need inpatient hospital care to treat your injury or illness
  • The hospital accepts Medicare
  • In some cases, the hospital’s Utilization Review Committee can approve your stay while you are in the hospital
As a Medicare Part A beneficiary, you can think of this as your “hospital coverage”. Medicare is going to help pay for a semi-private hospital room, meals, general nursing help, medications administered to you as part of inpatient treatment, as well some other medical supplies and hospital services.

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However, before Medicare Part A pays, you will be responsible for your Part A deductible for each benefit period. Your deductible would cover your Medicare approved expenses for the first 60 days of a benefit period. For example, you are sick and become an inpatient in a hospital on May 5 for 7 days. You would be responsible for your Part A deductible. Then on October 31 you are sick once again and are an inpatient for 3 days, you would be responsible for the deductible a second time. 
Medicare covers days 61-90, in your benefit period, after your per day coinsurance payment is met. In addition, you also have 60 lifetime reserve days of coverage with a per day coinsurance responsibility.    

You can receive inpatient hospital care services in:
  • Acute care hospitals
  • Critical illness hospitals
  • Inpatient rehabilitation facilities
  • Inpatient psychiatric facilities 
  • Long-term care hospitals
  • Inpatient care as part of a qualifying clinical research study
Part A also covers up to 190 lifetime days for inpatient mental health care in a psychiatric hospital.

Skilled nursing facility care stays are covered under Part A if you have spent at least 3 consecutive days in the hospital within 30 days of admission to a skilled nursing facility. You must have needed skilled nursing or therapy care for your injury or sickness. 
Home health care coverage under Part A will start if you have spent at least three days in a row as a hospital inpatient within 14 days of receiving home health care. The care must be per doctor’s orders, certified and reviewed regularly. Some of the services provided may include occupational therapy, physical therapy, part-time skilled nursing care, speech language pathology, medical social services and intermittent home health aide services.  Call us for more information today.

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