Medicare allows you to choose how you get your Medicare coverage. There are 2 principal methods to get Medicare coverage once you are enrolled in Original Medicare (Part A and Part B): 1. Add a Medicare Supplement plan or 2. Enroll in a Medicare Advantage Plan (Part C). Most individuals will also need to add Medicare prescription drug coverage (Part D).
Medicare is an entitlement program and most U.S. citizens are eligible to enroll in Medicare for working and paying their taxes for a period of time (generally 10 years). If you fear you haven’t worked long enough to be entitled to Medicare benefits, then you may still be eligible to enroll but may have to pay more.
Original Medicare includes both Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). Those who desire prescription drug coverage are required to join a separate Medicare drug plan – Part D.
Original Medicare stipulates that you can choose any doctor or hospital that accepts Medicare in the U.S. When you choose Original Medicare, you could also add Medicare Supplement Insurance (Medigap), Medicaid, or employee or union coverage, to help cover your costs.
Keep in mind that time is of the essence when you become eligible for Medicare drug coverage or Medigap coverage. You may have to pay more if you wait to get these coverages later. These premium penalties could haunt you for the duration of your time on Medicare. Speak with a Medicare Insurance Professional in AZ now for information about Medicare coverage.
Medicare Part A Coverage
Medicare Part A covers inpatient care in a hospital, skilled nursing facility care, nursing home care, inpatient care in a skilled nursing facility that’s not custodial or long-term care, hospice care, and home health care.
When unsure if Medicare Part A will cover a medical service that you need, you can ask your health care provider if it’s covered. If they’re unsure and you accept the service, then you may be asked to sign a notice that states you’ll have to pay for the item, service, or supply if Medicare doesn’t cover it.
Medicare Part A doesn’t cover everything. Medicare may not cover the following items:
- Cosmetic surgeries
- Custodial Care
- Eye examinations
- Hearing aids and examinations
- Most dental care
- Routine foot care
If you require items, services, or supplies that your Medicare plan doesn’t cover, then you’ll have to pay for them unless you have additional insurance coverage or a Medicare health plan that covers them.
FAQ About Medicare Part A – Hospital Insurance
Now that you have some background information about Medicare Part A, here are some of the frequently asked questions about Medicare and all its parts. Speak with a Medicare insurance professional right away if you still need clarity on your coverages.
Does Medicare Part A cover 100% of my hospitalization costs?
Medicare Part A normally doesn’t cover your full hospital bill and you will be responsible for a piece of the cost. You could have to pay a deductible before your Medicare benefits kick in.
Upon payment of your deductible, then Medicare will pay 100% of your costs for up to 60 days in the hospital or up to 20 days in a skilled nursing facility. After your benefits are used, then you’ll pay a flat amount up to the maximum number of covered days.
Medicare Part A benefits will cover some of the costs for up to 90 days in the hospital or 100 days in a skilled nursing facility. Medicare will also cover up to 60 lifetime reserve days. Lifetime reserve days are counted after you’ve stayed in a hospital for more than 90 days in a row.
How much are Medicare Part A monthly premiums?
The majority of Medicare Part A beneficiaries don’t pay a monthly premium for coverage. This is also called “premium-free Part A.” Typically, when you (or your spouse) have worked at least 10 years and paid Medicare taxes while working, then you’re eligible for premium-free Part A.
Does Medicare Part A cover doctors in the hospital?
Medicare Part A covers hospital expenses. Doctor visits, medical services, and supplies are normally covered under Medicare Part B.
Does Medicare Part A cover hospital emergency room visits?
Medicare Part A, also known as “hospital insurance,” covers the costs of an emergency room (ER) visit if you’re admitted to the hospital to treat the illness or injury that brought you to the ER. If your ER trip isn’t covered under your Medicare Part A plan, then you could be eligible to get coverage through Medicare Part B, C, D, or Medigap plans.
Can Medicare run out?
Generally, there’s not a dollar limit on your Medicare benefits. If the coverage you desire falls within the parameters of what Medicare covers, and those services are medically necessary, then you can continue to use as much as you need for as long as you require.
How do I cancel Medicare Part A?
If you desire to disenroll from your Medicare Part A coverage, then you can fill out CMS form 1763 which is the Request for Termination of Premium Hospital and Medical Insurance, and mail it to your local Social Security Administration office.
If you need to disenroll after the age of 65, then you will be required to pay back all of the money you’ve received from Social Security and any Medicare benefits paid on your behalf. You can always re-enroll by calling 1-800-772-1213 or visiting your local SSA office
Why choose Insurance Professionals of Arizona?
Understanding the basics of Medicare can help you understand the importance of finding the right plan that works for your situation. Insurance Professionals of Arizona is dedicated to educating the community about all of your Medicare and insurance options.
We use our experience to guide you through the process. We can help you evaluate all of the plans available and decide what’s best for you. Most importantly we will work to help you save money.