Medicare Part A covers inpatient hospital care and, in some circumstances, the care received in a nursing facility or at home. Specific requirements need to be met for this coverage to apply and, in this guide to Medicare Part A, we’ll look at those requirements and cover everything else you need to know.
Hospital Care Coverage
Medicare Part A will cover you for hospital care considered essential to your treatment, including critical care, mental health care, and rehabilitation. It will also cover you for a private room, but only if it is essential. It will not cover you for toiletries, phone chargers, and other peripheral charges accumulated during your stay.
Nursing Home Care Coverage
Medicare Part A covers you for a stay in a skilled nursing facility (SNF) if it follows a hospital stay of at least 3 consecutive days for a related illness.
The SNF must be a certified Medicare facility and, during your stay, you will be covered for:
- Basic daily living services and other essential services
- Necessary medical supplies
- Essential medical equipment
- Rehab services
- A semi-private room
To qualify, your doctor needs to confirm that these services are essential for your health and that they cannot be provided in your own home.
Medicare Part A can cover you for hospice costs if your doctor confirms that you have a terminal illness and have less than 6 months to live. You need to sacrifice curative treatments and focus on palliative care before you can qualify. The hospice must also be a Medicare-approved facility.
Typically, Medicare Part A will cover all of the medical and care services required under hospice care, including medical supplies, medical equipment, nursing care, homemaking services, and social services. It may also cover you for grief counseling.
Home Health Care Coverage
If considered necessary and recommended by a doctor, Medicare Part A will cover you for home care costs. This includes physical and occupational therapy performed in the home, both part-time and full-time skilled nursing care, and language therapy.
Other aspects of home care may also be covered. However, Medicare Part A will not cover you for meal services and other home care services if they are unrelated to your care.
When needed, home health care is covered 100%, but it must be provided by a certified agency and you must also be classed as housebound. This means you cannot leave the home, you cannot leave without a great deal of effort, or a doctor has recommended that you don’t leave home without the use of special equipment or transportation.
Who Qualifies for Medicare Part A?
You will be eligible for Medicare Part A if you are over the age of 65 and are either a US citizen or have lived as a legal permanent resident for at least 5 years. You may also qualify if you are under 65, provided you are disabled and are receiving disability benefits, have ALS, or have end-stage renal disease.
If you are already receiving social security benefits or Railroad Retirement Board benefits, you will be covered automatically. This begins not on the day you turn 65, but on the first day of your birth month in your 65th year. If your birthday is on the first, your coverage will begin the previous month.
For example, if your birthday is December 20th, your benefits will begin on December 1st. If your birthday is December 1st, they will begin on November 1st. If you have already enrolled for Medicare Part B, this will begin at the same time as Medicare Part A.
You should receive your Medicare card several months before your birthday.If your enrollment is not automatic, you must enroll manually. Assuming you qualify (see criteria above) you can enroll online, over the phone at 1-800-772-1213, or by visiting your local Social Security Office.