Understanding Medicare Part A

What is Medicare Part A?

Medicare is a federal health insurance program. It is divided into multiple “Parts” that allow individuals to choose their coverage based on specific health and lifestyle concerns. Some parts – Parts A and B – are administered by the federal government, while others – Parts C and D, as well as Medicare Supplement coverage – are provided by private insurance carriers with oversight from the federal program. Parts A and B are sometimes called “Original Medicare.”

Medicare is managed by a federal department called the Centers for Medicare and Medicaid Services (CMS).

Medicare

Medicare Made Easy Part Two: Medicare Part A vs. Medicare Part B

Play Video

Medicare coverage is available to people in the United States who are 65 and older. It’s also available to younger people who have a disability, End-Stage Renal Disease (ESRD), or ALS.

Many people are eligible for Medicare Part A with no premiums. Some of the taxes you pay if you are working go toward Medicare coverage. If you haven’t worked a total of ten years or longer, you may need to pay a premium for Medicare Part A.

The full explanation of what Part A covers within those services is complex.

Two principles, medical necessity and duration, can help you get an idea of what might be covered and where you could be responsible for costs.

Medical Necessity

Medical Necessity

Medicare makes many coverage decisions based on whether a service is deemed “medically necessary.” In the case of a hospital stay, for example, your doctor may have to order hospitalization for it to be covered by Medicare.

Medical Duration

DurationMedicare Supplement

The amount you may have to pay for care that is covered by Medicare Part A often depends on the duration of care. There is usually no coinsurance required for days 1-60 of a hospital stay, then daily coinsurance beyond day 60. Medicare does not usually cover additional expenses like a private room or personal care items.

Are You Eligible for a Medicare Advantage Plan with Additional Benefits?

Get a Free Quote from a Licensed Insurance Agent.

Get a Free Quote

Getting More Details

If you have questions or concerns about what will be covered or what you will pay with Medicare Part A coverage, you have a number of resources:

  • Compare costs through your online Medicare account

  • Ask your doctor or healthcare provider about what will be covered

  • Talk to the hospital about their relationship with Medicare and what will be covered during your stay

Additionally, you may be able to get assistance with your Medicare Part A costs through a Medicare Supplement Plan, a Medicare Advantage Plan, and the Extra Help program.

senior-woman-yellow-shirt

Get Medicare Coverage that Fits Your Needs

Explore Medicare Advantage Plans In Your Area

Get a Free Quote
senior-woman-red-scarf-e

Medicare Part B

senior-fashionista

Medicare Part C: Medicare Advantage

senior-man-in-sport-jack

Medicare Enrollment Periods: When to Sign Up?

Enrollment Eligibility

schedule(1)

Annual Enrollment Period (AEP)

Medicare Annual Enrollment Period runs each year from October 15 to December 7. What is the Annual Enrollment Period vs. Open Enrollment Period?

deadline

Initial Enrollment Period (IEP)

Your Initial Enrollment Period generally surrounds your 65th birthday but may occur if you otherwise become eligible for Medicare for the first time.

schedule

Special Enrollment Period (SEP)

You may be eligible if you experience a qualifying life event such as moving to a new zip code, losing employer coverage, or change in Medicaid status.

Speak to a Licensed Insurance Agent Today

1-844-735-2912 / TTY

Aetna® Anthem® Cigna Healthcare® Humana® UnitedHealthcare®