Understanding Medicare: Part A

Jolie

Member
Helps with the cost of inpatient hospital stays and skilled nursing services. It also helps with some hospice and skilled care for the homebound.

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Part A pays most of the cost of hospital stays lasting up to 60 days.

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What providers can I see?

You can choose any qualified provider in the United States that has been accepted by Medicare and is accepting new patients. It’s not limited to a state or region.

Coverage limits.

If you’re hospitalized for a long time (more than 90 days at one time), there are limits. This is true for a skilled nursing facility, too.

What is covered.

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What isn’t covered.

Doctor services in the hospital are covered by Part B, not Part A. And Part A won’t pay personal hospital costs, like a television or telephone calls, or for “custodial care”— help with things like eating, bathing, or dressing.

Costs.

Premiums. Part A is provided with no out of pocket costs, or premium, if you or your spouse have made payroll contributions to Social Security for at least 10 years (40 quarters). If you don’t meet the 10-year rule, the premium in 2010 is $461 a month.

Your share of the costs.

Deductible. You have to pay a deductible before Part A starts paying a share of your costs. In 2010, it’s $1,100 for each hospital stay, subject to certain limits.

Copay. After staying a certain number of days, you pay a copay. For 2010 hospital stays, it’s $275 per day (days 61-90); $550 per day (days 91-150).

Coinsurance. You pay a small coinsurance for in-patient respite care for hospice patients.

Enrolling

When can I join? As soon as you become eligible for Medicare.

How do I sign up?
If you’re getting Social Security when you become eligible, you’re
automatically enrolled. You can also sign up at your local Social Security office.

Can they refuse to cover me or delay coverage? Not if you’re eligible for Medicare. If you sign up when you first become eligible, coverage begins the first day of the month you become eligible.


 
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