Medicare Part A

What is Medicare Part A?

For people who currently have Original Medicare, or are thinking about getting the insurance plan, Medicare Part A accounts for half of the protection. Medicare Part A is provided through the Centers for Medicare & Medicaid Services and typically provides coverage for medical expenses incurred from inpatient care. As hospital insurance, it is accepted at most hospitals, nursing homes, skilled nursing facilities, and critical access hospitals across the nation. While the law requires doctors and suppliers to file Medicare claims for covered services, as the beneficiary, you usually do not have to file claims yourself.

What does Medicare Part A Cover?

Medicare Part A is coverage that helps shoulder the cost of doctor visits, medical services, and supplies. Below is a brief outline of the services covered when deemed medically necessary by a Medicare-assigned healthcare provider.

Blood Transfusions

In most instances, receiving blood at the hospital comes at no charge if the facility gets it from the blood bank. On the off chance that you do have to buy the blood, you will normally only be responsible for the first three units you get in a calendar year.

Hospital Stays

Most people would prefer to stay out of the hospital if they can avoid it. However, if you do find yourself having to spend a couple of nights, Medicare will generally cover the hospital stay. If the stay is covered, then the plan will usually cover a semi-private room, food, nursing care, and other hospital services and supplies.

To qualify for Medicare Part A coverage for hospital stays, you must meet the following requirements:

A doctor must deem it medically necessary for you to spend at least two nights in inpatient care.
The facility you go to accepts Medicare and has agreed to admit you as an inpatient.
The care you require can only be provided at a hospital.
The Utilization Review Committee has approved your stay at the hospital you are receiving treatment at.

Nursing Home or Skilled Nursing Facility Inpatient Stays

Medicare Part A will provide coverage for limited care in a skilled nursing facility if it is related to your diagnosis during a hospital stay. One of the most common instances is when patients suffer a stroke at the hospital and need to continue treatment for recovery after their hospital stay. In this case, the patient would be transferred to the nursing facility for a maximum of 100 days. For most plans, the first 20 days are paid for and the remainder of the stay requires a copayment.

Home Health Services

Once able to leave the hospital and nursing facility, some patients still require care after arriving home. If this is the case, Medicare Part A may provide for limited part-time care in the form of skilled nursing care, physical or continued occupational therapy, speech-language pathology, or home health aide services.

How We Can Help

Hitcho Insurance has supported clients and their families through the Medicare enrollment and coverage process for over 20 years. We get to know your goals and needs on a personal level through an in-depth one-on-one consultation process. It is our mission to work with you one step at a time until you are comfortable and understand all of the options available to you. To schedule a consultation with us, give us a call at (610) 694-9435.