Learn about Medicare Part A
Some people call it Traditional Medicare and some call it Original Medicare. Either way the federal government includes coverage called Medicare Part A to those eligible beneficiaries as part of the Medicare program.
I like to think of Part A as insurance for services received inside the four walls of a hospital. And if you've earned it, you get Part A premium free for the rest of your life.
How do you get Medicare Part A
Most people will be automatically enrolled in Medicare Part A just before their 65th birthday. This will certainly happen if you are receiving Social Security benefits, and you can expect Part B to start automatically also. If you are not receiving Social Security benefits then you'll want to sign up for Part A using one of these methods.
Medicare Part A gives access to most hospitals in the United States. Most people will pay a zero premium for this coverage.
- 1Apply online at the Social Security Administration website
- 2Call the Social Security Administration at 1-800-772-1213 and apply over the phone
- 3Visit your local Social Security office and apply in person
You'll want to make sure and sign up for Medicare within three months of your 65th birthday month. Delaying enrollment can potentially trigger a penalty and this must be avoided as the penalties are for the rest of your life!
Note.
If you sign up for Medicare the month of your birthday or any of the three months proceeding your birthday, coverage will begin on the 1st day of the next month.
What does Medicare Part A cover?
Medicare Part A is a type of Medicare insurance that covers inpatient hospital care, skilled nursing facility care, hospice care, and limited home health care services.
Here is a brief summary of what Medicare Part A covers:
Inpatient hospital care: Medicare Part A covers hospital care, including semi-private rooms, meals, general nursing, drugs as part of your inpatient treatment, and other hospital services and supplies.
Skilled nursing facility care: Medicare Part A covers skilled nursing care in a skilled nursing facility (SNF) under certain conditions, such as after a hospital stay of at least three days for the same illness or injury.
Hospice care: Medicare Part A covers hospice care for people who are terminally ill and have a life expectancy of six months or less. Hospice care can include palliative care, pain management, and other supportive services.
Home health care: Medicare Part A covers limited home health care services, such as skilled nursing care, physical therapy, speech-language pathology services, and occupational therapy, as part of a home health care plan ordered by a doctor.
It's important to note that Medicare Part A typically requires deductibles, coinsurance, and copayments for most services. The amount you pay will depend on the specific services you receive and whether you have additional Medicare coverage, such as Medicare Part B or a Medicare Supplement plan. See our Medicare Part A costs for 2023 here. Medicare Advantage plans will have their own cost structures for Part A services. They normally will have a per day copay or coinsurance amount for any hospital stays, but it will vary by the plan you are enrolled in.
Do I have to pay a monthly premium for Medicare Part A?
For most Medicare beneficiaries, Medicare Part A is premium free. So as long as you have paid Medicare taxes for a total of ten years in your lifetime, then you too shall pay 'No Premium' for Part A. If this is not your situation, then you will be billed a premium for Part A. Remember, if your spouse has accumulated at least 40 quarters of employment and paid Medicare taxes that you too shall have 'No Premium' Part A.
Do I get Medicare Part A if I'm disabled?
If you are receiving Social Security Disability Benefits, then yes you are eligible for Part A. You must wait a period of 24 months before your Part A benefits will begin, and the first day of the 25th month will be your effective date.
There are many plans available from private insurance companies that are specially designed to help someone who is eligible for Medicare due to a disability. These plans are known as SNP's or Special Needs Plans and you can learn more about them on our Medicare Disability Advantage Plans page.
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Questions & Answers
Yes, if you do not enroll in Medicare Part A when you were first eligible, and you are not entitled to Premium Free Part A. The penalty is calculated by increasing your monthly premium by 10%, and is doubled for every year you did not have coverage.
In most cases, Medicare Part A will not cover services outside of the US. However, if you have an emergency or need urgent care and the closest care facility is while you are abroad, then Medicare may pay some of these costs. Providers abroad most likely will not bill Medicare and you will be responsible to pay at the time of service. When you return to the US, you can forward your medical bills directly to Medicare for reimbursement.
If you are actively employed and still received group healthcare insurance past age 65, you can delay Part A enrollment, provided your employer has more than 20 full time employees. There are only two scenarios why you would do this however. First, you or your employer are contributing to a Health Savings Account, or you, or your spouse have not worked 40 quarters to grant you premium free Part A.
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Medicare can be confusing for most. We want to help you navigate the many options available to you, so please call us directly at (800) 405-4802 and chat with our insurance advisors for help.
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