What is Medicare Part A?

By | March 5, 2010

Medicare part A is part of the original Medicare system. It is run by the Federal government. The original Medicare system covers items such as medical services and supplies used in hospitals, in the doctor’s office and other health care settings. Medicare Part A covers your stay in the hospital. It is hospital insurance. Medicare Part B is for coverage in other, non-hospital, health care settings. Medicare Part C covers both Part A and Part B. Part D is Medicare Drug Coverage.

Part A covers inpatient care in hospitals. These include acute care (critical access) hospitals, inpatient rehabilitation facilities, and long-term care hospitals. Inpatient care in a skilled nursing facility is also covered; however, custodial long-term care is not covered. Other covered services include hospice care and home health care.

For individuals for whom medical care is not congruent with their religious belief and values, there is still part A covers inpatient care in a Religious Non-Medical Health Care Institution. In this case, Medicare will only cover the non-medical, non-religious health care items and services.

When you stay in a hospital, Medicare Part A includes a semi-private room, meals, general nursing and drugs. Other hospital services and supplies required by inpatient care are also covered. A private room is not covered unless medically necessary. Doctor’s services while you are in a hospital are not covered by Part A. These services are covered under Part B.

After a minimum three day inpatient stay a hospital, Part A will cover care in a skilled nursing facility for services related to illness or injury. In this case, the doctor must certify that you need daily skilled care. Examples of this are intravenous injections or physical therapy.

Hospice care is also cover, for people with a terminal illness. Your doctor must certify that you are expected to live 6 months or less. Hospice care may either be at inpatient facility, or provided at home. For home hospice care, Medicare Part A will provide for five days of respite.

Home health care is limited to medically-necessary part-time or intermittent services. These include skilled nursing care, physical therapy, speech-language pathology and occupational therapy. This care must be ordered by a doctor and be provided a Medicare-certified home health agency.

Medicare allows you your choice of healthcare providers. You can choose any doctor or hospital that accepts Medicare. Medicare Part A and Part B do not cover everything. There are gaps. You can fill those gaps by purchasing a Medigap health insurance policy. Medigap insurance can only be purchase from private insurance companies. You can check out the resources and links on this site to find more information.

Generally you do not pay a monthly premium for Part A coverage. This is true if you or your spouse have paid Medicare taxes while working, otherwise you are not eligible to receive Part A without paying a premium. You may be able to buy Part A if you either are age 65 or older, meet citizenship or residency requirements, and qualify for Part B. Or, you are under age 65, disabled, and you have returned to work, ending premium-free Medicare. Now you know what is Medicare Part A.